| 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 | $632 | $632 | 0.00% |
| RICHARD F. KIEFNER3 Filed as: RICHARD KIEFNER JR | 1356 WILLOW WOOD DRIVE NORFOLK, VA 23509 | OPTIMA HEALTH | $38K | $0 | $38K | 0.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 NONE | Contract Administrator; Non-monetary compensation; Other services; Direct payment from the plan; Claims processing; Participant communication; Float revenue Service code 12 | — | $17.1M |
| ALIGHT FKA AONHEWITT EIN 82-1061233 NONE | Consulting (pension); Consulting fees; Actuarial; Consulting (general) Service code 11 | — | $3.8M |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $979K |
| CVS CAREMARK NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services; Claims processing Service code 12 | CUSTOMER CARE CORRESPONDENCE P.O. BOX 6590 LEES SUMMIT, MO 64064 | $816K |
| GROOM LAW GROUP EIN 52-1219029 NONE | Legal Service code 29 | — | $350K |
| ADVANCE MEDICAL EIN 32-0188784 NONE | Participant communication; Other services Service code 38 | — | $340K |
| NATURALLY SLIM EIN 26-2868596 NONE | Other services Service code 49 | — | $280K |
| DIRECTPATH (FKA HIGHROADS) EIN 02-0677999 NONE | Consulting (general); Direct payment from the plan; Participant communication Service code 16 | — | $235K |
| WILLIS TOWERS WATSON EIN 53-0181291 NONE | Contract Administrator Service code 13 | — | $102K |
| JP MORGAN EIN 13-4994650 NONE | Investment advisory (plan); Float revenue; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $101K |
| GUIDESPARK NONE | Contract Administrator Service code 13 | 1400A SEAPORT BLVD, STE 500 REDWOOD CITY, CA 94063 | $65K |
| PEGGY EDGE CPA EIN 26-4527814 NONE | Accounting (including auditing) Service code 10 | — | $21K |
| PRICEWATERHOUSECOOPERS EIN 13-4008324 NONE | Accounting (including auditing) Service code 10 | — | $12K |
| KPMG LLP EIN 13-1673581 NONE | Accounting (including auditing) Service code 10 | — | $6K |
| CIGNA BEHAVIORAL HEALTH, INC. | Direct payment from the plan; Contract Administrator; Participant communication; Claims processing Service code 12 | — | $0 |
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 | 28,934 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 329 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 29,263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(8 contracts, 7 carriers) | OPTIMA HEALTH | 12,083 | $23.9M |
| Dental(4 contracts, 4 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,207 | $4.7M |
| Vision | VISION SERVICE PLAN | 21,131 | $3.8M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 41,733 | $22.5M |
| Short-term disability(3 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 2,043 | $227K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 41,733 | $25.1M |
| 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.