| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LYONS GLOBAL INSURANCE SERVICES LLC3 | 444 MADISON AVENUE NEW YORK, NY 10022 | AETNA LIFE INSURANCE CO. | $100K | — | $100K | 5.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06516 | $2.0M |
| HILB GROUP OF NEW ENGLAND LLC EIN 05-0474165 INSURANCE BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 931 JEFFERSON BLVD., STE. 3001 WARWICK, RI 02886 | $399K |
| DELTA DENTAL OF NEW JERSEY EIN 22-1896118 CLAIMS ADMINISTRATOR | Other services; Participant communication; Claims processing; Named fiduciary; Contract Administrator Service code 12 | 1639 ROUTE 10 PARSIPPANY, NJ 07054 | $112K |
| WEISER MAZARS EIN 13-1459550 AUDITOR | Accounting (including auditing) Service code 10 | 135 WEST 50TH STREET NEW YORK, NY 10020 | $79K |
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 | 5,710 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 42 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,752 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NJ, INC. | 3,134 | $1.8M |
| Vision | AETNA LIFE INSURANCE CO. | 5,710 | $2.0M |
| Life insurance | AETNA LIFE INSURANCE CO. | 5,710 | $2.0M |
| Short-term disability | AETNA LIFE INSURANCE CO. | 5,710 | $2.0M |
| Long-term disability | AETNA LIFE INSURANCE CO. | 5,710 | $2.0M |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 3,266 | $2.7M |
| Other | AETNA LIFE INSURANCE CO. | 5,710 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,710 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.