| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE PROGRAMMERS, INC. Filed as: INSURANCE PROGRAMMERS, INC | 10 TECHNOLOGY DRIVE WALLINGFORD, CT 06492 | HCC LIFE INSURANCE COMPANY | $4K | — | $4K | 1.66% |
| MPL LLC | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | ANTHEM HEALTH PLANS, INC. | $4K | — | $4K | 6.57% |
| INSURANCE PROGRAMMERS, INC. Filed as: INSURANCE PROGRAMMERS, INC | 10 TECHNOLOGY DRIVE WALLINGFORD, CT 06492 | UNION LABOR LIFE INSURANCE COMPANY | $821 | — | $821 | 1.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SAV-RX EIN 47-0527013 NONE | Claims processing Service code 12 | 224 NORTH PARK AVENUE FREMONT, NE 06492 | $207K |
| INSURANCE PROGRAMMERS INC EIN 06-0811449 NONE | Accounting (including auditing); Claims processing; Insurance brokerage commissions and fees Service code 10 | 10 TECHNOLOGY DRIVE WALLINGFORD, CT 06492 | $123K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Consulting (general) Service code 16 | 116 HUNTINGTON AVE, 8TH FLOOR BOSTON, MA 02116 | $20K |
| HOLM OHARA EIN 13-3591118 NONE | Legal Service code 29 | 3 WEST 35TH STREET, 9TH FLOOR NEW YORK, NY 10001 | $16K |
| BEERS, HAMERMAN, COHEN & BURGER PC EIN 47-2517893 NONE | Accounting (including auditing) Service code 10 | 234 CHURCH STREET NEW HAVEN, CT 06510 | $15K |
| OLSEN MOBECK INVESTMENT ADVISORS EIN 06-1082686 NONE | Investment management fees paid directly by plan Service code 51 | 1310 SILAS DEANE HIGHWAY, SUITE 201 WETHERSFIELD, CT 06109 | $14K |
| BUCKLEY, FRAME, BOUDREAU EIN 06-0931761 NONE | Accounting (including auditing) Service code 10 | — | $9K |
| HINES AND ASSOCIATES, INC EIN 36-3545085 NONE | Insurance services Service code 23 | 115 E. HIGHLAND DRIVE ELGIN, IL 60120 | $6K |
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 | 301 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 301 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS, INC. | 0 | $55K |
| Dental | ANTHEM HEALTH PLANS, INC. | 0 | $55K |
| Life insurance(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 247 | $292K |
| Other | UNION LABOR LIFE INSURANCE COMPANY | 247 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 247 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.