| 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. | $108K | — | $108K | 4.84% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 931 JEFFERSON BLVD., STE. 3001 WARWICK, RI 02886 | AETNA LIFE INSURANCE CO. | $2K | — | $2K | 0.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06516 | $1.3M |
| HILB GROUP OF NEW ENGLAND LLC EIN 05-0474165 INSURANCE BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 931 JEFFERSON BLVD., STE. 3001 WARWICK, RI 02886 | $392K |
| DELTA DENTAL OF NEW JERSEY EIN 22-1896118 CLAIMS ADMINISTRATOR | Other services; Participant communication; Contract Administrator; Named fiduciary; Claims processing Service code 12 | 1639 ROUTE 10 PARSIPPANY, NJ 07054 | $124K |
| NOVAK FRANCELLA EIN 61-1436956 AUDITOR | Accounting (including auditing) Service code 10 | 450 SEVENTH AVE., 28TH FL. NEW YORK, NY 10123 | $28K |
| SCHULTE ROTH & ZABEL PLAN COUNSEL | Legal Service code 29 | 919 THIRD AVE. NEW YORK, NY 10022 | $3K |
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 | 5,737 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 47 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,784 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 6,055 | $1.8M |
| Vision | AETNA LIFE INSURANCE CO. | 5,737 | $2.2M |
| Life insurance | AETNA LIFE INSURANCE CO. | 5,737 | $2.2M |
| Short-term disability | AETNA LIFE INSURANCE CO. | 5,737 | $2.2M |
| Long-term disability | AETNA LIFE INSURANCE CO. | 5,737 | $2.2M |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 3,145 | $2.9M |
| Other | AETNA LIFE INSURANCE CO. | 5,737 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,055 | — |
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."
No prospect flags tripped on this filing.