| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION | SYSTEMS, INC. 101 PARK AVE 14TH FLOOR NEW YORK, NY 10178 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $226K | — | $226K | 7.40% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $9K | $9K | 0.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY (G1728) EIN 31-1440175 NONE | Float revenue; Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.5M |
| MEDCO HEALTH SOLUTIONS, INC EIN 22-3461740 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $156K |
| COMMUNITY INSURANCE COMPANY | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $48K |
| HAWAII MEDICAL SERVICE ASSOCIATION EIN 99-0040115 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $25K |
| EYEMED VISION CARE EIN 31-1656473 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $21K |
| US BANK-CUSTODIAL FEES NONE | Consulting (general); Direct payment from the plan Service code 16 | 800 NICOLLET MALL MINNEAPOLIS, MN 55402 | $15K |
| HEALTH MANAGEMENT SYSTEMS INC EIN 38-2686158 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $6K |
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 | 2,713 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,887 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,600 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | EYEMED VISION CARE | 6,353 | $295K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,600 | $3.0M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,492 | $2.3M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,600 | $3.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,353 | — |
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."
No prospect flags tripped on this filing.