| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LYONS GLOBAL INSURANCE SERVICES LLC3 | 444 MADISON AVENUE, 18TH FL. NEW YORK, NY 10022 | HARTFORD LIFE AND ACCIDENT | $45K | — | $45K | 6.17% |
| LYONS GLOBAL INSURANCE SERVICES LLC3 | 444 MADISON AVENUE NEW YORK, NY 10022 | AETNA LIFE INSURANCE COMPANY | $38K | — | $38K | 34.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INNOVATIVE INSURANCE SPECIALISTS EIN 20-1842509 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $478K |
| HILB GROUP OF NEW ENGLAND LLC EIN 05-0474165 INSURANCE BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | $278K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06516 | $236K |
| DELTA DENTAL OF NEW JERSEY EIN 22-1896118 CLAIMS ADMINISTRATOR | Contract Administrator; Other services; Participant communication; Claims processing; Named fiduciary Service code 12 | 1639 ROUTE 10 PARSIPPANY, NJ 07054 | $123K |
| MULTIPLAN INC EIN 13-3068979 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $96K |
| 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 | $23K |
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 | 4,773 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 48 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,821 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 5,583 | $1.5M |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 5,797 | $1.7M |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 5,797 | $2.3M |
| Short-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 5,797 | $2.3M |
| Long-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 5,797 | $2.3M |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AMWINS/STOP LOSS INSURANCE SERVICES | 3,127 | $2.2M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 5,797 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,797 | — |
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.