No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Non-monetary compensation; Named fiduciary; Participant communication; Float revenue; Direct payment from the plan; Contract Administrator; Other services; Claims processing Service code 12 | — | $1.4M |
| SILVERSCRIPT INSURANCE COMPANY EIN 20-2833904 NONE | Account maintenance fees Service code 65 | — | $928K |
| NISA INVESTMENT ADVISORS LLC EIN 48-1140940 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $389K |
| BNY MELLON EIN 25-6078093 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $150K |
| CVS PHARMACY, INC. EIN 05-0340626 NONE | Claims processing; Contract Administrator; Participant communication; Other services; Direct payment from the plan Service code 12 | — | $69K |
| COHNREZNICK LLP EIN 22-1478099 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $50K |
| BUCK GLOBAL, LLC EIN 13-3954297 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $48K |
| COMPREHENSIVE PROFESSIONAL SYSTEMS EIN 13-3025997 NONE | Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication; Plan Administrator; Claims processing Service code 12 | — | $22K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Direct payment from the plan; Other fees; Shareholder servicing fees; Float revenue; Trustee (directed) Service code 25 | — | $21K |
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 | 6,409 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,409 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMBLEM HEALTH | 90 | $930K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 90 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.