| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 320 WEST 57TH STREET 5TH FLOOR NEW YORK, NY 10019 | HCC LIFE INSURANCE COMPANY | $86K | — | $86K | 11.89% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 320 WEST 57TH STREET 5TH FLOOR NEW YORK, NY 10019 | HCC LIFE INSURANCE COMPANY | $39K | — | $39K | 13.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD STE 1000 ROLLING MDWS, IL 60008 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | $9K | — | $9K | 5.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | $7K | — | $7K | 3.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | — | $2K | $2K | 1.26% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 320 WEST 57TH STREET 5TH FLOOR NEW YORK, NY 10019 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $11K | — | $11K | 8.90% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 320 WEST 57TH STREET 5TH FLOOR NEW YORK, NY 10019 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $6K | — | $6K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 320 WEST 57TH STREET 5TH FLOOR NEW YORK, NY 10019 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $6K | — | $6K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 320 WEST 57TH STREET 5TH FLOOR NEW YORK, NY 10019 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $4K | — | $4K | 10.00% |
| DAVIS VISION3 | 175 E HOUSTON STREET 5TH FLOOR SAN ANTONIO, TX 78205 | HM LIFE INSURANCE COMPANY | — | $1K | $1K | 4.50% |
| DAVIS VISION3 | 175 E HOUSTON STREET 5TH FLOOR SAN ANTONIO, TX 78205 | HM LIFE INSURANCE COMPANY | — | $249 | $249 | 4.51% |
| DAVIS VISION3 | 175 E HOUSTON STREET 5TH FLOOR SAN ANTONIO, TX 78205 | HM LIFE INSURANCE COMPANY | — | $173 | $173 | 4.50% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 701 B STREET 4TH FLOOR SAN DIEGO, CA 92101 | PRUDENTIAL | — | $528 | $528 | 14.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICE, LLC EIN 47-0854646 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $291K |
| ALLIANT INSURANCE SERVICES INC EIN 33-0785439 BROKER | Other commissions Service code 55 | 320 W 57TH STREET, FLOOR 3 NEW YORK, NY 10019 | $0 |
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 | 963 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 963 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 561 | $177K |
| Vision(3 contracts) | HM LIFE INSURANCE COMPANY | 245 | $42K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 963 | $62K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 227 | $58K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 222 | $45K |
| Stop-loss / reinsurancereinsurance(2 contracts) | HCC LIFE INSURANCE COMPANY | 456 | $1.0M |
| Other(3 contracts, 2 carriers) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 963 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 963 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.