| 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 | $250K | $0 | $250K | 2.79% |
| 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.) | $890 | $0 | $890 | 10.00% |
| CLEARY BENEFITS GROUP, INC.3 Filed as: CLEARY BENEFITS GROUP INC. | 83 WOOSTER HEIGHTS RD DANBURY, CT 06810 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3 | $0 | $3 | 3.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $4.2M |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 100 PARSONS POND DRIVE FRANKLIN LAKES, NJ 07417 | $235K |
| AETNA BEHAVIORAL HEALTH, LLC EIN 20-0446713 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $195K |
| HEALTH AND HUMAN RESOURCE CENTER EIN 33-0052273 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $23K |
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 | 13,231 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 13,231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 17,277 | $1.2M |
| Vision | AETNA LIFE INSURANCE CO. | 17,277 | $1.2M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 13,448 | $9.0M |
| Short-term disability(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 13,448 | $9.0M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 13,448 | $9.0M |
| Other(2 contracts, 2 carriers) | ZURICH AMERICAN INSURANCE COMPANY | 11,978 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 17,277 | — |
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.