| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEARY BENEFITS GROUP, INC.3 Filed as: CLEARY BENEFITS GROUP INC. | 83 WOOSTER HEIGHTS RD DANBURY, CT 06810 | SUN LIFE ASSURANCE COMPANY OF CANADA | $235K | $0 | $235K | 2.85% |
| CLEARY BENEFITS GROUP, INC.3 Filed as: CLEARY BENEFITS GROUP INC | 83 WOOSTER HEIGHTS RD DANBURY, CT 06810 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | $0 | $2K | 4.87% |
| MERCER HEALTH AND BENEFITS, LLC Filed as: MERCER | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | ZURICH AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 20.00% |
| CLEARY BENEFITS GROUP, INC.3 Filed as: CLEARY BENEFITS GROUP INC. | 83 WOOSTER HEIGHTS RD DANBURY, CT 06810 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $790 | $0 | $790 | 10.01% |
| CLEARY BENEFITS GROUP, INC.3 Filed as: CLEARY BENEFITS GROUP INC. | 83 WOOSTER HEIGHTS RD DANBURY, CT 06810 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4 | $0 | $4 | 2.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | 100 RYAN COURT, STE. 200 PITTSBURGH, PA 15205 | $3.2M |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CLAIMS ADMINISTRATOR | Named fiduciary; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Participant communication; Other services; Float revenue; Claims processing Service code 12 | 1601 CHESTNUT ST PHILADELPHIA, PA 19192 | $2.9M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $308K |
| CIGNA BEHAVORIAL HEALTH, INC. EIN 41-1648670 CLAIMS ADMINISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing; Participant communication Service code 12 | 11095 VIKING DR EDEN PRAIRIE, MN 55344 | $208K |
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 | 12,100 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 12,100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 2,699 | $615K |
| Vision(2 contracts) | UNITED HEALTHCARE INSURANCE COMPANY | 9,393 | $2.1M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 12,146 | $8.2M |
| Short-term disability(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 12,146 | $8.3M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 12,146 | $8.2M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 6,829 | $1.1M |
| Other | ZURICH AMERICAN INSURANCE COMPANY | 11,978 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,146 | — |
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."
No prospect flags tripped on this filing.