| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CVS INSURANCE SERVICES, INC. Filed as: CVS HEALTH | — | CVS HEALTH/CVS PHARMACY, INC | — | $2K | $2K | 1.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 144 TURNPIKE RD, STE 330 SOUTHBOROUGH, MA 01772 | CIGNA HEALTH & LIFE INSURANCE COMPANY (CIGNA) | $9K | — | $9K | 5.79% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH & LIFE INSURANCE COMPANY (CIGNA) | $6K | — | $6K | 3.87% |
| UMR, INC. Filed as: UNITED HEALTHCARE INSURANCE COMPANY | — | UNITED HEALTHCARE INSURANCE COMPANY | — | $9K | $9K | 7.51% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4564 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 2.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 NONE | Float revenue; Participant communication; Other services; Non-monetary compensation; Direct payment from the plan; Claims processing; Named fiduciary; Contract Administrator Service code 12 | — | $61K |
| SEI TRUST COMPANY EIN 04-2452803 NONE | Trustee (bank, trust company, or similar financial institution); Claims processing Service code 12 | — | $51K |
| CIGNA HEALTH & LIFE INSURANCE COMPA | Float revenue; Claims processing; Participant communication; Other services; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Contract Administrator Service code 12 | — | $0 |
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 | 47 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 43 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 90 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | 35 | $786K |
| Dental | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | 27 | $671K |
| Vision(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | 49 | $674K |
| Life insurance | SUN LIFE ASSURANCE COMP. OF CANADA | 53 | $17K |
| Short-term disability | SUN LIFE ASSURANCE COMP. OF CANADA | 53 | $17K |
| Long-term disability | SUN LIFE ASSURANCE COMP. OF CANADA | 53 | $17K |
| Prescription drug(3 contracts, 3 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | 49 | $876K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH & LIFE INSURANCE COMPANY (CIGNA) | 49 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 53 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.