| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VERIZON COMMUNICATIONS5 Filed as: VERIZON COMMUNICATIONS INC. | 500 SUMMIT LAKE DRIVE 3RD FLOOR VALHALLA, NY 10595 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $455K | $455K | 2.78% |
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION SY | 99 PARK AVE 25TH FLOOR NEW YORK, NY 10016 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $98K | — | $98K | 0.60% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHICAN AVE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $8K | $8K | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BANK OF NY MELLON EIN 13-5160382 NONE | Other services; Investment management fees paid directly by plan; Direct payment from the plan; Custodial (other than securities); Custodial (securities); Float revenue; Investment management; Trustee (bank, trust company, or similar financial institution) Service code 18 | — | $128K |
| PRUDENTIAL INSURANCE CO EIN 22-1211670 NONE | Investment management fees paid indirectly by plan; Soft dollars commissions; Contract Administrator; Investment management; Insurance agents and brokers; Investment management fees paid directly by plan Service code 13 | — | $110K |
| COMPSYCH EIN 35-3739783 NONE | Other insurance fees and expenses; Contract Administrator Service code 13 | — | $76K |
| THOMPSON HINE LLP EIN 34-0575300 NONE | Legal; Direct payment from the plan Service code 29 | — | $37K |
| KPMG LLC EIN 13-5565207 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $7K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 84,178 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 84,178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(23 contracts, 22 carriers) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 62,046 | $76.0M |
| Dental | AETNA INC. | 2,386 | $680K |
| Vision | EYEMED | 1,184 | $44K |
| Life insurance(4 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 54,850 | $25.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 62,046 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.