| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 | 280 GRANITE RUN DRIVE SUITE 250 LANCASTER, PA 17601 | AETNA LIFE INSURANCE COMPANY | $22K | — | $22K | 4.61% |
| BENEFITSTORE INC3 | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $1K | $23K | 16.68% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIR SUITE 4500 HUNT VALLEY, MD 21031 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $928 | $17K | 12.64% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE SUITE 4500 HUNT VALLEY, MD 21031 | VISION SERVICE PLAN | — | $22K | $22K | 21.02% |
| BENEFITSTORE INC3 | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $570 | $10K | 15.48% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIR SUITE 4500 HUNT VALLEY, MD 21030 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $461 | $8K | 12.79% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE, STE 4500 HUNT VALLEY, MD 21030 | HYATT LEGAL PLANS | $3K | — | $3K | 7.82% |
| CRAWFORD ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE SUITE 4500 HUNT VALLEY, MD 21031 | HYATT LEGAL PLANS | $657 | $446 | $1K | 2.72% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE SUITE 4500 HUNT VALLEY, MD 21031 | ZURICH AMERICAN INSURANCE COMPANY | $986 | — | $986 | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | — | $986 | $986 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGER | Float revenue; Claims processing; Other fees; Direct payment from the plan Service code 12 | — | $1.9M |
| CORESOURCE, INC. EIN 35-1846036 HEALTH | Plan Administrator; Other services; Claims processing Service code 12 | — | $514K |
| AETNA - PPO EIN 06-6033492 HEALTH | Other services; Claims processing Service code 12 | — | $135K |
| HEALTH FITNESS EIN 41-1580506 FITNESS | Claims processing Service code 12 | — | $114K |
| RIGHT RX CARE DBA US-RXCARE HEALTH | Other services; Claims processing Service code 12 | 6412 N. UNIVERSITY DRIVE SUITE 113 TAMARAC, FL 33321 | $56K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 DENTAL ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $51K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 EAP ADMINISTRATOR | Claims processing; Direct payment from the plan; Participant communication; Contract Administrator Service code 12 | — | $35K |
| CLEAR HEALTH STRATEGIES, LLC EIN 27-1374374 HEALTH | Claims processing; Other services; Plan Administrator Service code 12 | — | $31K |
| HEALTHCARE BLUEBOOK EIN 46-4399706 HEALTH | Other services; Plan Administrator; Claims processing Service code 12 | — | $29K |
| MULTIPLAN EIN 43-6004435 HEALTH | Other services; Claims processing; Plan Administrator Service code 12 | — | $27K |
| TELEDOC EIN 04-3705970 HEALTH | Other services; Claims processing Service code 12 | — | $20K |
| BENEFIT DATA SERVICES, LLC HEALTH | Other services; Claims processing Service code 12 | 1651 THIBODEAUX AVENUE SUITE B BATON ROUGE, LA 70806 | $6K |
| ACS - A XEROX COMPANY EIN 36-4129784 COMPUTER SERVICES | Other services; Claims processing Service code 12 | — | $6K |
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 | 1,305 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 75 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,390 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 967 | $105K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 1,305 | $476K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 1,305 | $476K |
| Other(5 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 1,305 | $724K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,305 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.