| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC. | P.O BOX 9465 NEW YORK, NY 10087 | HUMANA HEALTH PLAN, INC. | $34K | $12K | $47K | 1.21% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE., FLOOR 5 NEW YORK, NY 10017 | HUMANA HEALTH PLAN, INC. | $37K | — | $37K | 0.95% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE., FLOOR 5 NEW YORK, NY 10017 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $46K | — | $46K | 3.67% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE., FLOOR 5 NEW YORK, NY 10017 | HEALTH RESOURCES, INC. | $12K | — | $12K | 5.00% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE., FLOOR 5 NEW YORK, NY 10017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | — | $20K | 10.00% |
| COLONIAL LIFE & ACCIDENT3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17K | $2K | $19K | 12.38% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE., FLOOR 5 NEW YORK, NY 10017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | — | $16K | 19.88% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE., FLOOR 5 NEW YORK, NY 10017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 10.00% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE., FLOOR 5 NEW YORK, NY 10017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE., FLOOR 5 NEW YORK, NY 10017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
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 | 648 | 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) | 648 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA HEALTH PLAN, INC. | 594 | $5.1M |
| Dental | HEALTH RESOURCES, INC. | 565 | $247K |
| Vision | HUMANA HEALTH PLAN, INC. | 561 | $3.9M |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 648 | $267K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 648 | $349K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 648 | $59K |
| Prescription drug | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 594 | $1.2M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 648 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 648 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.