| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.7 Filed as: HAYS COMPANIES | 133 FEDERAL ST 2ND FL BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $63K | $20K | $83K | 7.90% |
| HAYS COMPANIES, INC.7 Filed as: HAYS COMPANIES | 133 FEDERAL ST 2ND FL BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $2K | $12K | 11.77% |
| NATIONAL GROUP PROTECTION INC3 | 1445 GREENBRIAR PLACE CHARLOTTESVILLE, VA 22901 | RELIASTAR LIFE INSURANCE COMPANY | $787 | — | $787 | 3.72% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KINLOCH CONSULTING GROUP INC | 25 MELVILLE PARK RD STE 260 MELVILLE, NY 11747 | RELIASTAR LIFE INSURANCE COMPANY | $525 | — | $525 | 2.48% |
| HAYS COMPANIES, INC.7 Filed as: HAYS COMPANIES | 133 FEDERAL ST 2ND FL BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $228 | $228 | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 | Other services; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan; Named fiduciary; Contract Administrator; Float revenue Service code 12 | — | $405K |
| AMWINS GROUP BENEFITS EIN 05-0461576 | Float revenue; Claims processing; Direct payment from the plan Service code 12 | — | $26K |
| BUCHBINDER TUNICK & CO LLP EIN 13-1578842 | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $25K |
| SEAFARERS VACATION FUND EIN 13-5602047 | Direct payment from the plan; Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $14K |
| BASIL CASTROVINCI ASSOCIATES INC EIN 13-2831500 | Direct payment from the plan; Actuarial Service code 11 | — | $8K |
| OPTUMRX, INC. EIN 33-0441200 | Other fees; Direct payment from the plan; Claims processing; Float revenue Service code 12 | — | $7K |
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 | 417 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 151 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 568 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 256 | $1.1M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 281 | $106K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 601 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 601 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.