| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & CO | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | HARTFORD LIFE AND ACCIDENT | $0 | $1K | $1K | 0.00% |
| RICHARD F. KIEFNER3 Filed as: RICHARD KIEFNER JR | 1356 WILLOW WOOD DRIVE NORFOLK, VA 23509 | OPTIMA HEALTH | $42K | $0 | $42K | 0.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 NONE | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Non-monetary compensation; Float revenue Service code 12 | — | $17.7M |
| HEWITT ASSOCIATES LLC EIN 36-2235791 NONE | Consulting fees; Actuarial; Consulting (general); Consulting (pension) Service code 11 | — | $4.4M |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $986K |
| CVS CAREMARK NONE | Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | CUSTOMER CARE CORRESPONDENCE P.O. BOX 6590 LEES SUMMIT, MO 64064 | $932K |
| ADVANCE MEDICAL EIN 32-0188784 NONE | Other services; Participant communication Service code 38 | — | $328K |
| GROOM LAW GROUP EIN 52-1219029 NONE | Legal Service code 29 | — | $293K |
| DIRECTPATH (FKA HIGHROADS) EIN 02-0677999 NONE | Consulting (general); Direct payment from the plan; Participant communication Service code 16 | — | $203K |
| NATURALLY SLIM EIN 26-2868596 NONE | Other services Service code 49 | — | $175K |
| XEROX RECOVERY SERVICES NONE | Contract Administrator; Consulting (general) Service code 13 | P.O. BOX 5025 DES PLAINES, IL 600175025 | $104K |
| BUDCO HEALTH SERVICES SOLUTIONS EIN 38-1622051 NONE | Other services; Other fees; Participant communication; Consulting fees Service code 38 | — | $83K |
| JP MORGAN EIN 13-4994650 NONE | Investment advisory (plan); Float revenue; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $73K |
| KPMG LLP EIN 13-1673581 NONE | Accounting (including auditing) Service code 10 | — | $64K |
| GUIDESPARK NONE | Contract Administrator Service code 13 | 1400A SEAPORT BLVD, STE 500 REDWOOD CITY, CA 94063 | $60K |
| PEGGY EDGE CPA EIN 26-4527814 NONE | Accounting (including auditing) Service code 10 | — | $17K |
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 | 30,240 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 337 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 30,577 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(8 contracts, 7 carriers) | OPTIMA HEALTH | 13,450 | $25.1M |
| Dental(4 contracts, 4 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,322 | $5.3M |
| Vision | VISION SERVICE PLAN | 20,949 | $3.8M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 41,733 | $22.7M |
| Short-term disability(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,370 | $280K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 41,733 | $25.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 41,733 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.