| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 NORTHFIELD DRIVE, THIRD FLOOR WINDSOR, CT 06095 | AETNA LIFE INSURANCE COMPANY | $111K | $0 | $111K | 2.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 700 BROADWAY DENVER, CO 80273 | ANTHEM HEALTH PLANS, INC. (G1800) | $0 | $10K | $10K | 1.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 NORTHFIELD DRIVE, THIRD FLOOR WINDSOR, CT 06095 | SYMETRA LIFE INSURANCE COMPANY | $17K | $0 | $17K | 8.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE, FLOOR 14 ITASCA, IL 601433177 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.95% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BEECHER CARLSON INS SERVICES INC | 914 HARTFORD TURNPIKE WATERFORD, CT 06385 | HARTFORD LIFE AND ACCIDENT | $382 | $0 | $382 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $24K |
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 | 287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 96 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 6 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 389 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 657 | $4.9M |
| Dental | AETNA LIFE INSURANCE COMPANY | 657 | $4.4M |
| Vision | VISION SERVICE PLAN | 313 | $44K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 376 | $209K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 376 | $207K |
| Prescription drug | ANTHEM HEALTH PLANS, INC. (G1800) | 121 | $576K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 657 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.