| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INNOVATIVE INSURANCE SPECIALISTS3 | 46 PRINCE ST., STE. 206 NEW HAVEN, CT 06519 | STEALTH PARTNERS GROUP | $25K | $25K | $50K | 2.03% |
| LYONS GLOBAL INSURANCE SERVICES LLC3 | 444 MADISON AVE., 18TH FL. NEW YORK, NY 10022 | HARTFORD LIFE AND ACCIDENT | $121K | — | $121K | 5.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMWINS CONNECT ADMINISTRATORS, INC. EIN 52-1200892 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $805K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 RX ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $416K |
| IHP EIN 20-1842509 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $398K |
| 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 | $335K |
| SISCO BENEFITS CLAIMS ADMINISTRATOR | Claims processing Service code 12 | 800 MAIN STREET DUBUQUE, IA 52001 | $167K |
| DELTA DENTAL OF NEW JERSEY EIN 22-1896118 CLAIMS ADMINISTRATOR | Participant communication; Named fiduciary; Contract Administrator; Claims processing; Other services Service code 12 | 1639 ROUTE 10 PARSIPPANY, NJ 07054 | $112K |
| TELEMED EIN 20-1842509 TELEMEDICINE | Claims processing; Contract Administrator Service code 12 | — | $107K |
| AMERICAN HEALTH HOLDINGS EIN 75-2493178 UTILIZATION REVIEW | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $81K |
| AETNA EIN 06-6033492 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $54K |
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 | 4,510 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 78 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,588 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 4,913 | $1.5M |
| Vision | AETNA LIFE INSURANCE CO. | 5,083 | $228K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 4,510 | $2.1M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 4,510 | $2.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 4,510 | $2.1M |
| Stop-loss / reinsurancereinsurance | STEALTH PARTNERS GROUP | 4,893 | $2.4M |
| Other | HARTFORD LIFE AND ACCIDENT | 4,510 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,083 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.