| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 30 BRAINTREE HILL OFFICE PARK, SUIT BRAINTREE, MA 02184 | HCC LIFE | $3K | — | $3K | 5.00% |
| HILB GROUP OF NEW ENGLAND Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 30 BRAINTREE HILL OFFICE PARK, SUIT BRAINTREE, MA 02184 | HCC LIFE | — | $939 | $939 | 1.78% |
| NELSON INSURANCE CONSULTING Filed as: NELSON INSURANCE CONSULTING INC | 1143 SHIPWATCH CIRCLE TAMPA, FL 33602 | HCC LIFE | — | $317 | $317 | 0.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHERN BENEFIT ADMINISTRATORS INC EIN 62-1116095 NONE | Plan Administrator Service code 14 | — | $144K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Claims processing; Non-monetary compensation; Participant communication; Float revenue; Other services; Contract Administrator; Direct payment from the plan Service code 12 | — | $102K |
| DELTA DENTAL OF THE D.C. OF COLUMBI EIN 52-1479587 NONE | Contract Administrator Service code 13 | — | $24K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $19K |
| SLEVIN & HART EIN 52-1708613 NONE | Legal Service code 29 | — | $17K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 20-8764829 NONE | Investment advisory (plan); Custodial (securities); Direct payment from the plan Service code 19 | — | $15K |
| TELEMEDICINE MANAGEMENT, INC NONE | Other services Service code 49 | 801 SPRINGDALE DRIVE EXTON, PA 19341 | $13K |
| EMPATHIA INC. NONE | Other services Service code 49 | N17W24100 RIVERWOODS DR, 300 WAUKESHA, WI 53188 | $5K |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 213 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 373 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HCC LIFE | 205 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.