| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | ONE FINANCIAL PLAZA HARTFORD, CT 06103 | ANTHEM HEALTH PLANS, INC. | $2K | $0 | $2K | 3.61% |
| ASSUREDPARTNERS3 | 445 HAMILTON AVENUE, 10TH FLOOR WHITE PLAINS, NY 10601 | ANTHEM HEALTH PLANS, INC. | $805 | $0 | $805 | 1.72% |
| ASSUREDPARTNERS3 | 435 WHITTINGTON PARKWAY, SUITE 300 LOUISVILLE, KY 40222 | ANTHEM HEALTH PLANS, INC. | $0 | $687 | $687 | 1.47% |
| ASSUREDPARTNERS3 | 1300 WINSTED ROAD TORRINGTON, CT 06790 | ANTHEM LIFE INSURANCE COMPANY | $7K | $0 | $7K | 19.84% |
| ASSUREDPARTNERS3 | 755 MAIN STREET HARTFORD, CT 06103 | ANTHEM LIFE INSURANCE COMPANY | $5K | $0 | $5K | 14.06% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | ANTHEM LIFE INSURANCE COMPANY | -$7K | $0 | -$7K | -19.84% |
| LOCKTON COMPANIES, LLC3 | 65 MEMORIAL ROAD, SUITE C100 RUTHERFORD BUILDING WEST HARTFORD, CT 06107 | ANTHEM LIFE INSURANCE COMPANY | -$7K | $0 | -$7K | -19.84% |
| LOCKTON COMPANIES, LLC3 | THREE EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | ANTHEM LIFE INSURANCE COMPANY | $3K | $0 | $3K | 14.54% |
No Schedule C service providers reported on this filing.
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ANTHEM HEALTH PLANS, INC. | 134 | $47K |
| Life insurance(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 109 | $51K |
| Short-term disability(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 109 | $51K |
| Long-term disability(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 109 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.