| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS & COMP. SYS. INC. | 101 PARK AVE FL 14 NEW YORK, NY 101782103 | METROPOLITAN LIFE INSURANCE COMPANY | — | $139K | $139K | 2.01% |
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS & COMP. SYS. INC. | 101 PARK AVE FL 14 NEW YORK, NY 101782103 | METROPOLITAN LIFE INSURANCE COMPANY | — | $69K | $69K | 2.00% |
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS & COMP. SYS. INC. | 101 PARK AVE FL 14 NEW YORK, NY 101782103 | METROPOLITAN LIFE INSURANCE COMPANY | — | $12K | $12K | 1.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILLIS TOWERS WATSON EIN 53-0181291 NONE | Direct payment from the plan; Other services; Contract Administrator; Actuarial Service code 11 | — | $2.5M |
| HIGHMARK EIN 23-1294723 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $590K |
| NORTHERN TRUST COMPANY EIN 36-1561860 NONE | Investment management; Direct payment from the plan; Trustee (directed) Service code 25 | — | $458K |
| CAPITAL INTERNATIONAL INC EIN 95-4154361 NONE | Direct payment from the plan; Investment management Service code 28 | — | $368K |
| PACIFIC INVESTMENT MANAGEMENT CO. EIN 33-0629048 NONE | Investment management; Direct payment from the plan Service code 28 | — | $338K |
| UNITED HEALTHCARE EIN 41-1289245 NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $260K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $202K |
| RUANE, CUNNIFF & GOLDFARB LLC EIN 77-0615921 NONE | Investment management; Direct payment from the plan Service code 28 | — | $149K |
| CME GROUP INC. EIN 36-4340266 NONE | Other services; Direct payment from the plan Service code 49 | — | $133K |
| CIGNA NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | PO BOX 15964 WILMINGTON, DE 19580 | $63K |
| CROWE LLP EIN 35-0921680 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $51K |
| BELL LITHO EIN 36-2550923 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $35K |
| MORGAN LEWIS EIN 23-0891050 NONE | Legal; Direct payment from the plan Service code 29 | — | $30K |
| DELTA DENTAL NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | PO BOX 1809 ALPHARETTA, GA 300231809 | $12K |
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 | 25,535 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 25,535 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | HUMANA INSURANCE COMPANY | 2,289 | $5.0M |
| Vision(3 contracts) | EYEMED VISION CARE | 132 | $12K |
| Life insurance(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 20,809 | $11.0M |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 172 | $2.1M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 2,293 | $602K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 20,809 | — |
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.