| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS INSURANCE3 Filed as: CROSS INSURANCE INC | 2 CORPORATE DRIVE SUITE 335 SHELTON, CT 06484 | HARTFORD LIFE AND ACCIDENT | — | $21K | $21K | 0.40% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DR STE 2 AUGUSTA, ME 04330 | VISION SERVICE PLAN | $5K | — | $5K | 1.01% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 8299 PASADENA, CA 91109 | VISION SERVICE PLAN | $5K | — | $5K | 0.97% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE-CONNECTICUT | 2 CORPORATE DRIVE SUITE 335 SHELTON, CT 06484 | HARTFORD LIFE AND ACCIDENT | $23K | — | $23K | 15.00% |
| ACBI, INC.3 Filed as: ACBI,INC | PO BOX 1388 BANGOR, ME 04402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 6.02% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC | 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $324 | — | $324 | 0.23% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE-SHELTON | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | FEDERAL INSURANCE COMPANY | $8K | $264 | $8K | 15.50% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 120670 SAN DIEGO, CA 92101 | HUMANA HEALTH PLANS OF PUERTO RICO INC. | $531 | — | $531 | 2.48% |
| ACBI, INC.3 Filed as: ACBI, INC | PO BOX 1388 BANGOR, ME 04402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 22.29% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| ACBI, INC.3 Filed as: ACBI, INC | PO BOX 1388 BANGOR, ME 04402 | FIRST UNUM LIFE INSURANCE COMPANY | $224 | — | $224 | 11.79% |
| ACBI, INC.3 Filed as: ACBI, INC, A MAINE CORPORATION | 491 MAIN ST BANGOR, ME 04401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 ADMIN SERVICES AGREEMENT | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Insurance mortality and expense charge; Named fiduciary; Non-monetary compensation; Float revenue Service code 12 | — | $3.9M |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $16K |
| CVS CAREMARK EIN 05-0340626 ADMIN SERVICES AGREEMENT | Participant communication; Float revenue; Named fiduciary; Contract Administrator; Non-monetary compensation; Claims processing; Other services; Direct payment from the plan Service code 12 | — | -$203K |
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 | 5,811 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 65 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 774 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,650 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA HEALTH PLANS OF PUERTO RICO INC. | 9 | $21K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NJ, INC. | 10,776 | $4.2M |
| Vision(3 contracts, 3 carriers) | VISION SERVICE PLAN | 4,522 | $563K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 8,378 | $5.3M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 8,378 | $5.3M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 8,378 | $5.3M |
| Other(6 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 8,378 | $5.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,776 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.