| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 Filed as: AON CONSULTING-BOSTON | PO BOX 905494 CHARLOTTE, NC 28905 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 6.35% |
| GENCORP INSURANCE GROUP INC3 Filed as: GENCORP INSURANCE GROUP, INC. | 16 MAIN STREET EAST GREENWICH, RI 02818 | FEDERAL INSURANCE COMPANY | — | $211 | $211 | 1.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNUM LIFE INSURANCE CO. OF AMERICA EIN 01-0278678 N/A | Other services Service code 49 | — | $79K |
| BLACKROCK EIN 94-3112180 RECORD-KEEPER | Investment management; Investment management fees paid directly by plan; Trustee (discretionary); Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $34K |
| WILLIS TOWERS WATSON EIN 26-0775680 N/A | Other services Service code 49 | — | $8K |
| GRAYCLIFF MEZZANINE II PARALLEL LP EIN 36-4711561 RECORD-KEEPER | Investment management Service code 28 | — | $6K |
| STATE STREET GLOBAL ADVISORS EIN 04-0025081 RECORD-KEEPER | Investment management fees paid directly by plan Service code 51 | — | $3K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 3,555 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,369 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,924 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | COMBINED INSURANCE COMPANY OF AMERICA | 4,115 | $240K |
| Life insurance | AMICA LIFE INSURANCE COMPANY | 4,608 | $4.0M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,311 | $442K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,311 | $442K |
| Other(2 contracts, 2 carriers) | GUIDEONE SPECIALTY MUTUAL INSURANCE COMPANY | 3,555 | $178K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,608 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.