No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS INC. EIN 06-1475928 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $2.7M |
| UFCW UNION LOCAL 919 PENSION EIN 06-1065206 RELATED ORG | Direct payment from the plan; Other services Service code 49 | — | $382K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $280K |
| OPTUMRX ADMINISTRATIVE SERVICES, LL EIN 75-2578509 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $182K |
| EMPLOYEE 4 EIN 06-6069081 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $172K |
| VIRTA MEDICAL PC EIN 36-4841662 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $154K |
| HINGE HEALTH, INC. EIN 81-1884841 NONE | Other services; Direct payment from the plan Service code 49 | — | $147K |
| UNION PRINTING, INC. NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 45 WESTBRIDGE DR. WATERBURY, CT 06708 | $135K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $121K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $114K |
| EMPLOYEE 8 EIN 06-6069081 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $97K |
| SEMO LAW GROUP NONE | Legal; Direct payment from the plan Service code 29 | 1710 CONNECTICUT AVE NW STE 300 WASHINGTON, DC 20009 | $92K |
| EMPLOYEE 7 EIN 06-6069081 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $79K |
| EMPLOYEE 5 EIN 06-6069081 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $78K |
| LIVONGO HEALTH, INC. EIN 26-3542036 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $77K |
| FIRST AMERICAN ADMINISTRATORS EIN 86-0773195 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $76K |
| EMPLOYEE 1 EIN 06-6069081 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $72K |
| EMPLOYEE 2 EIN 06-6069081 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| EMPLOYEE 3 EIN 06-6069081 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| PREMIER TECHNOLOGY SOLUTIONS, INC. EIN 13-3933805 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $57K |
| EMPLOYEE 6 EIN 06-6069081 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $46K |
| INTERCONTINENTAL REAL ESTATE CORP EIN 04-2895544 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $20K |
| ADP EIN 22-1467904 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $13K |
| MORGAN STANLEY EIN 20-8764829 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $11K |
| BOYD WATTERSON ASSET MGMT. EIN 34-1922005 NONE | Direct payment from the plan; Investment management Service code 28 | — | $8K |
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 | 24,247 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 623 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 24,870 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 399 | $1.3M |
| Dental | DELTA DENTAL OF CONNECTICUT, INC. | 33,006 | $7.3M |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 24,827 | $682K |
| Prescription drug | BLUE MEDICARE RX | 0 | $820K |
| Other(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 24,827 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 33,006 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.