| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTINE ANDREWS3 | PO BOX 466 FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 5.06% |
| PROFESSIONAL PENSIONS INC3 | 10 RESEARCH PKWY WALLINGFORD, CT 06492 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $857 | $2K | 1.18% |
| CHRISTINE ANDREWS3 | PO BOX 466 FARMINGTON, CT 06034 | AETNA LIFE INSURANCE CO. | $4K | — | $4K | 5.89% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | AETNA LIFE INSURANCE CO. | $555 | — | $555 | 0.92% |
| CHRISTINE ANDREWS3 | PO BOX 466 FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 15.23% |
| PROFESSIONAL PENSIONS INC3 | 10 RESEARCH PKWY WALLINGFORD, CT 06492 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $276 | $69 | $345 | 1.78% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | AMERITAS LIFE INSURANCE CORP. | $0 | $100 | $100 | 1.39% |
| CHRISTINE ANDREWS3 Filed as: CHRISTINE ADREWS | 3 FOREST PARK DRIVE FARMINGTON, CT 060321468 | AMERITAS LIFE INSURANCE CORP. | $0 | $41 | $41 | 0.57% |
| METTILLE, MARK S3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | AMERITAS LIFE INSURANCE CORP. | $0 | $0 | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $73K |
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 | 151 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE CO. | 141 | $60K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 134 | $7K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 151 | $229K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 151 | $210K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 151 | $210K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO. | 133 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.