No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $440K |
| BLUE CROSS BLUE SHIELD OF WISCONSIN EIN 39-0138065 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing; Other fees; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 165 COURT ST ROCHESTER, NY 14647 | $185K |
| COMPCARE HEALTH SERVICES INSURANCE EIN 39-1462554 CONTRACT ADMINISTRATOR | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Contract Administrator Service code 12 | 2270 EASTRIDGE CENTER EAU CLAIRE, WI 54701 | $499 |
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 | 372 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 372 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 372 | $0 |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS AND BLUE SHIELD | 625 | $339K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 625 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.