| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: BWD AGENCY INC. | 45 EXECUTIVE DRIVE PLAINVIEW, NY 118031703 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $22K | $33K | 3.09% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 1250 S. CAPITAL OF TEXAS HIGHWAY BUILDING 2, SUITE 125 AUSTIN, TX 787466446 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $0 | $9K | 0.88% |
| ASSUREDPARTNERS3 Filed as: BWD AGENCY INC. | 45 EXECUTIVE DRIVE PLAINVIEW, NY 11803 | LINCOLN LIFE ANNUITY COMPANY OF NEW YORK | — | $10K | $10K | 1.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $1.4M |
| HIGHMARK DE EIN 51-0020405 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $218K |
| AETNA BEHAVIRORAL HEALTH, LLC CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $62K |
| VISION SERVICE PLAN EIN 22-2777159 CONTRACT ADMINISTRATSING | Claims processing; Contract Administrator Service code 12 | — | $38K |
| HEALTH AND HUMAN RESOURCE CENTER CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $4K |
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 | 2,625 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 125 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,750 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,900 | $1.1M |
| Long-term disability | LINCOLN LIFE ANNUITY COMPANY OF NEW YORK | 1,980 | $731K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,919 | $508K |
| Other(2 contracts, 2 carriers) | HYATT LEGAL PLANS | 2,625 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,900 | — |
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.