| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAKESH BANSAL3 | 1 HORSESHOE CT MONROE, NJ 08831 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $16K | — | $16K | 4.63% |
| RAKESH BANSAL3 | 1 HORSESHOE CT MONROE TOWNSHIP, NJ 08831 | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 8.00% |
| NYLIFE SECURITIES LLC3 | 51 MADISON AVE, ROOM 251 NEW YORK, NY 10010 | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $876 | $876 | 0.75% |
| RAKESH BANSAL3 | 1 HORSESHOE COURT MONROE TOWNSHIP, NJ 08831 | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.68% |
| NYLIFE SECURITIES LLC3 | 51 MADISON AVE, ROOM 251 NEW YORK, NY 10010 | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $839 | $839 | 0.85% |
| RAKESH BANSAL3 | 1 HORSESHOE CT MONROE TOWNSHIP, NJ 08831 | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 8.82% |
| NY LIFE SECURITIES LLC3 | 41 MADISON AVE RM 251 NEW YORK, NY 10010 | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $793 | $793 | 0.83% |
| NYLIFE SECURITIES LLC3 Filed as: NYLIFE SECURITES LLC | 51 MADISON AVE, ROOM 251 NEW YORK, NY 10010 | FIRST UNUM LIFE INSURANCE COMPANY | — | $221 | $221 | 0.75% |
| RAKESH BANSAL3 | 1 HORSESHOE CT MONROE, NJ 08831 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| NYLIFE SECURITIES LLC5 | 51 MADISON AVE, ROOM 251 NEW YORK, NY 10010 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $205 | $205 | 0.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, LLC EIN 47-0854646 CLAMS PROCESSOR | Claims processing; Other services Service code 12 | — | $80K |
| RAKESH R BANSAL BROKER | Other commissions Service code 55 | 100 OVERLOOD CTR FL S PRINCETON, NJ 085407814 | $25K |
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 | 1,135 | 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) | 1,135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 58 | $335K |
| Vision | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 222 | $27K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | 542 | $215K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 58 | $335K |
| Stop-loss / reinsurancereinsurance | FIRST UNUM LIFE INSURANCE COMPANY | 80 | $29K |
| Other | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 542 | — |
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.