| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE PROGRAMMERS, INC. | PO BOX 5817 WALLINGFORD, CT 064927617 | HCC LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| GROUP BENEFIT ADMINISTRATORS OF CT3 | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 9.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS INC. EIN 06-1475928 | Other services Service code 49 | 1351 WM HOWARD TAFT ROAD CINCINNATI, OH 452061721 | $67K |
| INSURANCE PROGRAMMERS, INC. EIN 06-0811449 | Claims processing Service code 12 | PO BOX 5817 WALLINGFORD, CT 06492 | $42K |
| AETNA EIN 06-6033492 | Other services Service code 49 | 141 FARMINGTON AVENUE HARTFORD, CT 06156 | $5K |
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 | 271 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 271 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 271 | $14K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 180 | $379K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 271 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.