| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFIT ADMINISTRATORS OF CT3 | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | ANTHEM LIFE INSURANCE COMPANY | $12K | — | $12K | 1.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE EIN 06-0850110 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 609 WEST JOHNSON AVE, 2ND FLOOR CHESHIRE, CT 06410 | $414K |
| ROBERT M CHEVERIE ASSOCIATES PC EIN 06-1335139 NONE | Legal; Direct payment from the plan Service code 29 | 333 EAST RIVER DRIVE EAST HARTFORD, CT 06108 | $330K |
| THE SEGAL COMPANY INC EIN 13-1835864 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | 116 HUNTINGTON AVENUE BOSTON, MA 02116 | $280K |
| S M ESPOSITO & COMPANY PC EIN 06-1298465 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 3013 DIXWELL AVENUE HAMDEN, CT 06518 | $201K |
| CHANGE HEALTHCARE PAYMENT MGMT EIN 20-5731067 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 3055 LEBANON PIKE NASHVILLE, TN 37214 | $136K |
| EXECUTIVE DIRECTOR EIN 06-0850110 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 609 WEST JOHNSON AVE, 2ND FLOOR CHESHIRE, CT 06410 | $131K |
| IT DIRECTOR EIN 06-0850110 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 609 WEST JOHNSON AVE, 2ND FLOOR CHESHIRE, CT 06410 | $103K |
| SOFTWARE SYSTEMS SOLUTIONS LLC EIN 06-1496327 NONE | Consulting (general); Direct payment from the plan Service code 16 | 212 NEW LONDON TPKE GLASTONBURY, CT 06033 | $77K |
| UBS FINANCIAL SERVICES INC EIN 13-2638166 NONE | Other fees; Investment management fees paid directly by plan; Custodial (securities); Account maintenance fees; Investment advisory (plan) Service code 19 | ONE JERICHO PLAZA, SUITE 205 JERICHO, NY 11753 | $58K |
| WEBSTER BANK EIN 06-1187536 NONE | Other services; Other fees; Direct payment from the plan Service code 49 | 80 ELM STREET NEW HAVEN, CT 06510 | $23K |
| CT MICRONET LLC EIN 20-2841553 NONE | Consulting (general); Direct payment from the plan Service code 16 | 6 EXECUTIVE DRIVE FARMINGTON, CT 06032 | $20K |
| GREGORY SEELENBINDER NONE | Direct payment from the plan; Other services Service code 49 | 3482 TRENTON ROAD COLUMBUS, OH 43232 | $14K |
| PATRICIA SANDILLO FORMER EMPLOYEE | Consulting (general); Employee (plan); Direct payment from the plan Service code 16 | 3 CHARBEN LANE WALLINGFORD, CT 06492 | $12K |
| DENNIS MCGUIRE EIN 06-0850110 EMPLOYER CO CHAIR | Trustee (individual); Direct payment from the plan Service code 20 | — | $8K |
| JOHN CAPOBIANCO EIN 06-0850110 UNION CO-CHAIR | Direct payment from the plan; Trustee (individual) Service code 20 | — | $7K |
| JONATHAN ZUCKER, DMB NONE | Consulting (general); Other services; Direct payment from the plan Service code 16 | 48 CAMELOT DRIVE SHREWSBURY, MA 01545 | $7K |
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 | 6,022 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 424 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4,966 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 11,412 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 4,811 | $734K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 4,811 | $734K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,811 | — |
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.