| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MPL LLC3 | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | ANTHEM HEALTH PLANS, INC. | $25K | — | $25K | 7.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS, INC. EIN 06-1475928 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Claims processing Service code 12 | — | $219K |
| R. HERTEL EIN 06-1013879 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| D. STARR EIN 06-1013879 EMPLOYEE | Employee (plan) Service code 30 | — | $44K |
| PETER J. REIMER, LLC EIN 83-0366061 NONE | Actuarial Service code 11 | — | $40K |
| ENVISIONRX EIN 90-1011712 NONE | Contract Administrator; Claims processing Service code 12 | — | $36K |
| K. NORDBERG EIN 06-1013879 EMPLOYEE | Employee (plan) Service code 30 | — | $33K |
| METLIFE EIN 13-5581829 NONE | Contract Administrator; Claims processing Service code 12 | — | $32K |
| REID & RIEGE EIN 06-0867204 NONE | Legal Service code 29 | — | $29K |
| V. URBANO EIN 06-1013879 EMPLOYEE | Employee (plan) Service code 30 | — | $25K |
| BOSTON TRUST & INVESTMENT COMPANY EIN 04-2273811 NONE | Investment management Service code 28 | — | $25K |
| BEERS, HAMERMAN, COHEN & BURGER, PC EIN 47-2517893 NONE | Accounting (including auditing) Service code 10 | — | $17K |
| ROBERT M. CHEVERIE & ASSOC., PC EIN 06-1335139 NONE | Legal Service code 29 | — | $14K |
| LHV EMPLOYEE ASSISTANCE PROGRAM EIN 13-3240307 NONE | Other services Service code 49 | — | $14K |
| NEPC EIN 04-2927339 NONE | Investment advisory (plan) Service code 27 | — | $13K |
| CT COALITION TH HEALTH FUNDS EIN 22-3176650 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $8K |
| INFORMATION TECHNOLOGY GROUP EIN 06-1140281 NONE | Other services Service code 49 | — | $7K |
| WELLS FARGO BANK EIN 94-1347393 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Custodial (securities) Service code 15 | — | $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 | 445 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 224 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 669 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 448 | $49K |
| Prescription drug | ENVISION INSURANCE COMPANY | 305 | $411K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS, INC. | 470 | $352K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 470 | — |
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.