| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| C M SMITH AGENCY, INC.3 Filed as: C.M. SMITH AGENCY, INC. | 100 PEARL STREET, 3RD FL. WEST TOWER HARTFOED, CT 06103 | UNITED HEALTHCARE INSURANCE COMPANY | $86K | $0 | $86K | 4.36% |
| C M SMITH AGENCY, INC.3 Filed as: C. M. SMITH AGENCY, INC. | 100 PEARL STREET, 3RD FL. WEST TOWER HARTFOED, CT 06103 | DELTA DENTAL OF CT, INC. | $5K | $0 | $5K | 3.52% |
| C M SMITH AGENCY, INC.3 Filed as: C. M. SMITH AGENCY, INC. | 100 PEARL STREET, 3RD FL. WEST TOWER HARTFOED, CT 06103 | AETNA LIFE INSURANCE COMPANY | $13K | $0 | $13K | 11.81% |
| C M SMITH AGENCY, INC.3 Filed as: C. M. SMITH AGENCY, INC. | 100 PEARL STREET, 3RD FL. WEST TOWER HARTFOED, CT 06103 | EYEMED VISION CARE | $1K | $0 | $1K | 8.92% |
No Schedule C service providers reported on this filing.
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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 296 | $2.0M |
| Dental | DELTA DENTAL OF CT, INC. | 142 | $136K |
| Vision | EYEMED VISION CARE | 245 | $15K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 153 | $111K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 153 | $111K |
| Other | AETNA LIFE INSURANCE COMPANY | 153 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 296 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.