| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEDGWICK CLAIMS MANAGEMENT SERVICES5 Filed as: SEDGWICK CLAIMS MGMT SERVICES, INC | 2620 THOUSAND OAKS BLVD MEMPHIS, TN 15233 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $168K | $168K | 3.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL EIN 22-1211670 ADMIN FEES | Other fees; Contract Administrator; Claims processing; Other insurance fees and expenses Service code 12 | — | $199K |
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 | 2,085 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 32 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | METLIFE | 1,168 | $348K |
| Dental | ALPHA DENTAL PROGRAMS, INC. | 301 | $44K |
| Vision | EYEMED VISION CARE | 3,706 | $179K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,426 | $4.3M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,426 | $4.3M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,426 | $4.3M |
| Other(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,426 | $4.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,706 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.