| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTINE ANDREWS3 | 3 FOREST PARK DRIVE P.O. BOX 466 FARMINGTON, CT 06034 | OXFORD HEALTH INSURANCE, INC. | $101K | — | $101K | 1.80% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTIC, GA 30339 | OXFORD HEALTH INSURANCE, INC. | $5K | — | $5K | 0.09% |
| CHRISTINE ANDREWS3 Filed as: CHRISTINE ANDREWS, ANDREWS AGENCY | P.O. BOX 466 FARMINGTON, CT 06034 | AETNA LIFE INSURANCE CO. | $18K | $10K | $28K | 6.57% |
| ROGERS BENEFIT GROUP INC3 | 5110 N. 40TH STREET SUITE 234 PHOENIX, AZ 85018 | AETNA LIFE INSURANCE CO. | $13K | — | $13K | 3.04% |
| CHRISTINE ANDREWS3 | P.O. BOX 466 FARMINGTON, CT 06034 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $18K | — | $18K | 5.44% |
| ANDREWS BENEFITS3 Filed as: ANDREWS, CHRISTINE, S | 3 FORREST PARK DR. FARMINGTON, CT 06032 | AMERITAS LIFE INSURANCE CORP. | $5K | — | $5K | 10.00% |
| METTILLE, MARK S3 Filed as: METTILLE, MARK, S | 422 WAUPONSEE ST MORRIS, IL 60450 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | AMERITAS LIFE INSURANCE CORP. | — | $2K | $2K | 3.83% |
No Schedule C service providers reported on this filing.
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OXFORD HEALTH INSURANCE, INC. | 733 | $5.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 423 | $338K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 787 | $50K |
| Life insurance | AETNA LIFE INSURANCE CO. | 817 | $433K |
| Short-term disability | AETNA LIFE INSURANCE CO. | 817 | $433K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 817 | $433K |
| Other | AETNA LIFE INSURANCE CO. | 817 | $433K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 817 | — |
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.
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.