| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS AND COMP SYS INC. | 99 PARK AVENUE 25TH FLOOR NEW YORK, NY 100161601 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $236K | $236K | 1.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES LLC EIN 47-0854646 NONE | Other services; Claims processing; Direct payment from the plan Service code 12 | — | $981K |
| PIMCO EIN 33-0629048 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $187K |
| CVS PHARMACY, INC. EIN 06-0340626 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $88K |
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 NONE | Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Named fiduciary; Contract Administrator; Float revenue; Participant communication Service code 12 | — | $73K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $36K |
| WESTERN ASSET MANAGEMENT CO, LLC NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 385 EAST COLORADO BLVD PASADENA, CA 91101 | $31K |
| ANDERSEN TAX EIN 33-1197384 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $10K |
| ADP, INC. EIN 13-3036745 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $5K |
| JPMORGAN CHASE BANK NA EIN 13-4994650 PLAN TRUSTEE | Trustee (bank, trust company, or similar financial institution); Float revenue Service code 21 | — | $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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20,104 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 20,104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRIPLE-S, INC. | 22 | $108K |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 136 | $57K |
| Vision | VISION SERVICE PLAN | 1,283 | $134K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 26,135 | $16.4M |
| Prescription drug | TRIPLE-S, INC. | 22 | $108K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 26,135 | $16.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 26,135 | — |
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.