| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS & COMP | 101 PARK AVE 14TH FLOOR NEW YORK, NY 10178 | HARTFORD LIFE AND ACCIDENT | $210K | $170K | $380K | 5.05% |
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS & COMP | 101 PARK AVE 14TH FLOOR NEW YORK, NY 10178 | HARTFORD LIFE AND ACCIDENT | -$22K | $4K | -$18K | -9.07% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 120670 SAN DIEGO, CA 92101 | HUMANA HEALTH PLANS OF PUERTO RICO INC. | $1K | — | $1K | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERCIVES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $2.9M |
| CVS CAREMARK EIN 05-0340626 ADMIN SERVICES AGREEMENT | Named fiduciary; Direct payment from the plan; Contract Administrator; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | — | $104K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $16K |
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 | 6,166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 76 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 113 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,355 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA HEALTH PLANS OF PUERTO RICO INC. | 9 | $24K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NJ, INC. | 11,465 | $4.8M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 4,946 | $598K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 8,738 | $7.5M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 8,738 | $7.5M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 8,738 | $7.5M |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 8,738 | $7.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,465 | — |
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."
No prospect flags tripped on this filing.