| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | EXCELLUS BLUE CROSS BLUE SHIELD | $55K | $0 | $55K | 4.06% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 11311 MCCORMICK RD SUITE 500 HUNT VALLEY, MD 21031 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $38K | $38K | 3.28% |
| PSA INSURANCE & FINANCIAL PARTNERS3 | 11311 MCCORMICK RD SUITE 500 HUNT VALLEY, MD 21031 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | -$2K | -$2K | -0.15% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | DELTA DENTAL OF PENNSYLVANIA | $34K | $0 | $34K | 6.12% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY LLC - | ASSURANCE 20 N MARTINGALE RD SCHAUMBURG, IL 60173 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $52K | $2K | $53K | 12.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | NEW YORK LIFE (LIFE INSURANCE COMPANY OF NORTH AMERICA) | $44K | $9K | $53K | 13.67% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | NEW YORK LIFE (LIFE INSURANCE COMPANY OF NORTH AMERICA) | $15K | $7K | $23K | 7.05% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY LLC - | ASSURANCE 20 N MARTINGALE RD SCHAUMBURG, IL 60173 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $0 | $12K | 8.60% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | NEW YORK LIFE (LIFE INSURANCE COMPANY OF NORTH AMERICA) | $3K | $3K | $6K | 6.47% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | $0 | $7K | 9.06% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.09% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | NEW YORK LIFE (LIFE INSURANCE COMPANY OF NORTH AMERICA) | $6K | $1K | $7K | 13.53% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $0 | $4K | 7.44% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.88% |
| SEE ATTACHED3 | — | AFLAC -CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 10.48% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | NEW YORK LIFE (LIFE INSURANCE COMPANY OF NORTH AMERICA) | $744 | $87 | $831 | 16.75% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCS INS GRP INC | 1 KELLY WAY SPARKS, MD 21152 | ALLSTATE - AMERICAN HERITAGE LIFE INSURANCE COMPANY | $24 | $0 | $24 | 2.70% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | COUNTRYWIDE PRE-PAID LEGAL | $55 | $0 | $55 | 9.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INDEPENDENCE BLUE CROSS EIN 23-2184623 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Other fees Service code 12 | — | $298K |
| MERITAIN HEALTH EIN 61-1264154 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Insurance brokerage commissions and fees Service code 12 | — | $145K |
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Other fees Service code 12 | — | $102K |
| AMERIFLEX EIN 27-2256926 NONE | Claims processing; Other fees Service code 12 | — | $25K |
| CURALINC, LLC EIN 33-1206383 NONE | Other services; Other fees Service code 49 | — | $24K |
| FURTHER NONE | Other fees; Claims processing Service code 12 | 3535 BLUE CROSS ROAD EAGAN, MN 55122 | $1K |
| WEX INC EIN 01-0526993 NONE | Claims processing; Other fees Service code 12 | — | $500 |
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 | 1,496 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,500 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | EXCELLUS BLUE CROSS BLUE SHIELD | 111 | $3.0M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 786 | $556K |
| Vision | VISION SERVICE PLAN | 646 | $74K |
| Life insurance(3 contracts, 3 carriers) | NEW YORK LIFE (LIFE INSURANCE COMPANY OF NORTH AMERICA) | 1,133 | $527K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 454 | $238K |
| Long-term disability(2 contracts, 2 carriers) | NEW YORK LIFE (LIFE INSURANCE COMPANY OF NORTH AMERICA) | 1,136 | $463K |
| Prescription drug(3 contracts, 2 carriers) | EXCELLUS BLUE CROSS BLUE SHIELD | 111 | $3.0M |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HM LIFE INSURANCE COMPANY | 476 | $1.9M |
| Other(9 contracts, 6 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 1,133 | $374K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,136 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.