| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LYONS GLOBAL INSURANCE SERVICES LLC3 | 444 MADISON AVE 18TH FLOOR NEW YORK, NY 10022 | HARTFORD LIFE AND ACCIDENT | $143K | — | $143K | 6.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LEADING EDGE ADMINISTRATORS CLAIMS ADMINISTRATOR | Claims processing Service code 12 | 14 WALL STREET SUITE 5B NEW YORK, NY 10005 | $856K |
| GBS EIN 52-1200892 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $702K |
| AETNA EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $285K |
| GLOBAL RX MANAGEMENT RX ADMINISTRATOR | Claims processing Service code 12 | 1321 UPLAND DRIVE SUITE 819 HOUSTON, TX 77043 | $277K |
| EXPRESS SCRIPTS, INC EIN 43-1420563 RX ADMINISTRATOR | Claims processing Service code 12 | — | $215K |
| PAYFLEX HSA ADMINISTRATION | Plan Administrator Service code 14 | PO BOX 2239 OMAHA, NE 681032239 | $199K |
| DELTA DENTAL OF NEW JERSEY EIN 22-1896118 CLAIMS ADMINISTRATOR | Participant communication; Other services; Named fiduciary; Contract Administrator; Claims processing Service code 12 | — | $166K |
| BENEFITS CONNECT ONLINE BENEFITS VENDOR | Plan Administrator Service code 14 | 2000 CHAPEL VIEW BLVD SUITE 240 CRANSTON, RI 02920 | $159K |
| SCHULTE ROTH AND ZABEL LEGAL SERVICES | Legal Service code 29 | 919 THIRD AVENUE NEW YORK, NY 10022 | $62K |
| NOVAK FRANCELLA EIN 61-1436956 ACCOUNTNG SERVICES | Accounting (including auditing) Service code 10 | — | $50K |
| OPTUM FINANCIAL, INC EIN 47-0858530 FSA VENDOR | Plan Administrator Service code 14 | — | $30K |
| M&T BANK BANKING SERVICES | Trustee (bank, trust company, or similar financial institution) Service code 21 | 327 GREAT OAKS BLVD ALBANY, NY 122035971 | $9K |
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 | 4,810 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,810 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW JERSEY, INC | 4,666 | $1.5M |
| Vision | AETNA LIFE INSURANCE CO. | 4,760 | $220K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 4,810 | $2.3M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 4,810 | $2.3M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 4,810 | $2.3M |
| Stop-loss / reinsurancereinsurance | THE NORTH RIVER INSURANCE COMPANY | 4,531 | $2.5M |
| Other | HARTFORD LIFE AND ACCIDENT | 4,810 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,810 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.