| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS CONSULTING LLC3 | 99 PARK AVENUE, 25TH FLOOR NEW YORK, NY 10016 | SECURIAN LIFE INSURANCE COMPANY | $65K | — | $65K | 2.25% |
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS & COMP. SYSTEMS | 99 PARK AVENUE, FL 25 NEW YORK, NY 10016 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $37K | $37K | 2.64% |
| AMERICAN BENEFITS CONSULTING LLC3 | 99 PARK AVENUE, 25TH FLOOR NEW YORK, NY 10016 | SECURIAN LIFE INSURANCE COMPANY | $31K | — | $31K | 2.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 NONE | Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $5.9M |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Float revenue; Claims processing; Participant communication; Other services; Non-monetary compensation; Direct payment from the plan; Contract Administrator Service code 12 | — | $423K |
| HUMANA EIN 27-1649291 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $332K |
| CAREMARK-CVS PHARMACY INC. EIN 05-0340626 NONE | Claims processing; Other services Service code 12 | ONE CVS DRIVE WOONSOCKET, RI 02895 | $109K |
| CIGNA HEALTH & LIFE INSURANCE CO | Other services; Float revenue; Direct payment from the plan; Contract Administrator; Participant communication; Claims processing; Non-monetary compensation Service code 12 | — | $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 | 10,075 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 166 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 10,241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 25,018 | $1.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 227 | $1.7M |
| Vision(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 24,429 | $3.1M |
| Life insurance(2 contracts) | SECURIAN LIFE INSURANCE COMPANY | 10,065 | $4.3M |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 15,256 | $1.4M |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 15,256 | $1.4M |
| Other | FEDERAL INSURANCE COMPANY | 16,161 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 25,018 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.