| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE ST STE 1710 US BOSTON, MA 02109 | SECURIAN LIFE INSURANCE COMPANY | — | $79K | $79K | 1.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE EIN 36-2739571 NONE | Account maintenance fees Service code 65 | — | $18.2M |
| CONNECTICUT GENERAL LIFE EIN 06-0303370 NONE | Account maintenance fees Service code 65 | — | $1.3M |
| CAREMARK EIN 55-0712129 NONE | Account maintenance fees Service code 65 | — | $1.1M |
| BEST DOCTOR EIN 04-2908444 NONE | Account maintenance fees Service code 65 | — | $600K |
| OMADA HEALTH EIN 45-2355015 NONE | Account maintenance fees Service code 65 | — | $528K |
| MCCONNELL & JONES LLP EIN 76-0488832 AUDITOR | Accounting (including auditing) Service code 10 | — | $53K |
| STANDISH MELLON ASSET MANAGEMENT EIN 23-3094847 NONE | Investment management Service code 28 | — | $7K |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 10 | $51K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 4,809 | $852K |
| Life insurance | SECURIAN LIFE INSURANCE COMPANY | 27,772 | $4.5M |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 4,809 | $852K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 27,772 | — |
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."
Final-filing indicator set. Plan is winding down; don't waste sales effort here.