| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE FL 5 NEW YORK, NY 10017 | UNIMERICA INSURANCE COMPANY | $32K | — | $32K | 11.12% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS, INC. | P.O. BOX 9465 NEW YORK, NY 100879465 | UNIMERICA INSURANCE COMPANY | $11K | — | $11K | 3.88% |
| DAVIDSON JAMES DUNCAN3 Filed as: DAVIDSON, JAMES, DUNCAN | 1820 E 1ST ST STE 400 SANTA ANA, CA 92868 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 2.11% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - NEW YORK | PO BOX 905494 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 1.48% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC. | MARSH JCS INC FKA SLIA INC PO BOX 9465 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 1.22% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - COLUMBUS | PO BOX 905494 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $101 | — | $101 | 0.04% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE 5TH FLOOR NEW YORK, NY 10017 | UNITEDHEALTHCARE INSURANCE COMPANY | $12K | — | $12K | 10.31% |
| SUMITOMO LIFE INSURANCE AGENCY3 Filed as: SUMITOMO LIFE INS AGENCY AMERI | 2500 NORTHWINDS PKWY STE 370 ALPHARETTA, GA 300092247 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | — | $7K | 19.61% |
| SUMITOMO LIFE INSURANCE AGENCY3 Filed as: SUMITOMO LIFE INSURANCE AGENCY, | ATTN KAYOKO DEMPSEY 565 5TH AVE - FLOOR 2 NEW YORK, NY 10017 | AETNA INTERNATIONAL | $164 | — | $164 | 15.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 NONE | Claims processing; Other services Service code 12 | — | $374K |
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 | 685 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,363 | $34K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 685 | $114K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 685 | $114K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 697 | $290K |
| Other(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 878 | $395K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,363 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.