| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED GROUP BROKERAGE CORP.3 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | HCC LIFE INSURANCE COMPANY | $3K | — | $3K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIVERSIFIED ADMINISTRATION CORP. EIN 06-0988547 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | $192K |
| CORPORATE MANAGED HEALTH SERVICES EIN 06-1421429 UTILIZATION REVIEW | Contract Administrator Service code 13 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | $30K |
| DAVID W. SULLIVAN AGENT | Custodial (securities) Service code 19 | 7 WATER STREET SOUTH GLASTONBURY, CT 06073 | $6K |
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 | 167 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HCC LIFE INSURANCE COMPANY | 0 | $12K |
| Other(2 contracts, 2 carriers) | HM LIFE INSURANCE COMPANY | 167 | $399K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.