| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH ST., STE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $69K | — | $69K | 5.55% |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: BROWN & BROWN INSURANCE SERVICES, I | 11220 ASSET LOOP STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $10K | $10K | 0.81% |
| HAYS COMPANIES, INC.7 Filed as: HAYS COMPANIES | 80 SOUTH 8TH ST., STE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | — | $15K | 9.22% |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: BROWN & BROWN INSURANCE SERVICES, I | 11220 ASSET LOOP STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 0.83% |
| IBENEFIT COMMUNICATION LLC3 Filed as: IBENEFIT COMMUNICATION, LLC | 6230 FAIRVIEW RD STE 210 CHARLOTTE, NC 282103150 | RELIASTAR LIFE INSURANCE COMPANY | $1K | $349 | $2K | 4.21% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 532263286 | RELIASTAR LIFE INSURANCE COMPANY | $288 | $163 | $451 | 1.15% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 532263286 | RELIASTAR LIFE INSURANCE COMPANY | $394 | — | $394 | 1.01% |
| NATIONAL GROUP PROTECTION INC3 | 1445 GREENBRIAR PLACE CHARLOTTESVILLE, VA 22901 | RELIASTAR LIFE INSURANCE COMPANY | $233 | — | $233 | 0.59% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KINLOCH CONSULTING GROUP INC | 25 MELVILLE PARK RD STE 260 MELVILLE, NY 11747 | RELIASTAR LIFE INSURANCE COMPANY | $136 | — | $136 | 0.35% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES INC | 5000 DEARBORN CIR STE 100 MOUNT LAUREL, NJ 080544108 | RELIASTAR LIFE INSURANCE COMPANY | $9 | — | $9 | 0.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 980 WASHINGTON ST SUITE 325 DEDHAM, MA 02026 | EYEMED VISION CARE | $871 | — | $871 | 2.49% |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: BROWN & BROWN INSURANCE SERVICES, I | 11220 ASSET LOOP STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $56 | $56 | 0.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 | Other fees; Float revenue; Claims processing; Direct payment from the plan Service code 12 | — | $1.7M |
| AMWINS GROUP BENEFITS EIN 05-0461576 | Claims processing Service code 12 | — | $1.2M |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 | Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services Service code 12 | — | $654K |
| WEAVER AND TIDWELL, L.L.P. EIN 75-0786316 | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $24K |
| 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 | — | $17K |
| BASIL CASTROVINCI ASSOCIATES INC EIN 13-2831500 | Direct payment from the plan; Actuarial Service code 11 | — | $8K |
| EVERNORTH CARE SOLUTIONS, INC. EIN 86-1465626 | Participant communication; Direct payment from the plan; Claims processing; Contract Administrator 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 | 403 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 153 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 556 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 475 | $35K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 226 | $1.3M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 284 | $158K |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 558 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 558 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.