| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 | 10 N PARK DR STE 200 HUNT VALLEY, MD 21030 | HARTFORD LIFE INSURANCE COMPANY | $18K | — | $18K | 9.14% |
| IMA, INC.3 | 1705 17TH ST STE 100 DENVER, CO 80202 | HARTFORD LIFE INSURANCE COMPANY | $11K | — | $11K | 5.86% |
| IMA, INC.3 | PO BOX 2992 WICHITA, KS 67201 | HARTFORD LIFE INSURANCE COMPANY | — | $2K | $2K | 1.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP, LLC. EIN 77-0385729 CONTRACT ADMIN | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $462K |
| BLUE CROSS EIN 95-4331852 PPO/UR VENDOR | Other fees; Direct payment from the plan Service code 50 | — | $400K |
| DELTA DENTAL OF COLORADO EIN 83-4416613 DENTAL ADMIN | Claims processing; Contract Administrator Service code 12 | — | $59K |
| COMPSYCH EIN 36-3739783 ADMIN | Claims processing; Contract Administrator Service code 12 | — | $50K |
| WEX HEALTH INC. EIN 06-1593514 COBRA ADMIN | Contract Administrator; Claims processing Service code 12 | — | $41K |
| RX BENEFITS, INC. EIN 63-1157085 RX ADMIN | Contract Administrator; Claims processing Service code 12 | — | $11K |
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 | 1,712 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,722 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,402 | $154K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,712 | $185K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,712 | $52K |
| Long-term disability | LIFE INSURANCE COMPANY OF AMERICA | 1,724 | $271K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE INSURANCE COMPANY | 1,712 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,724 | — |
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.