| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KTP ADVISORS, INC.4 Filed as: KTP ADVISORS INC | 130 BELLEVUE AVE STE 211 NEWPORT, RI 028403291 | HUMANA INSURANCE COMPANY | $412K | — | $412K | 4.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON PARTNERS INC | 36 S CHARLES ST STE 1000 BALTIMORE, MD 212013020 | METROPOLITAN LIFE INSURANCE COMPANY | — | $30K | $30K | 1.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFITS MANAGEMENT GROUP, INC. EIN 20-0188125 NONE | Contract Administrator Service code 13 | — | $561K |
| UMR INC EIN 39-1995276 NONE | Claims processing Service code 12 | — | $223K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Custodial (securities); Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Investment management Service code 19 | — | $153K |
| DELTA DENTAL EIN 31-0685339 NONE | Claims processing Service code 12 | — | $84K |
| WELLS FARGO EIN 94-1347393 NONE | Investment management fees paid indirectly by plan; Custodial (securities) Service code 19 | — | $79K |
| RHUMBLINE EIN 04-3118582 NONE | Investment management Service code 28 | — | $61K |
| BOLTON PARTNERS INVESTMENT CONSULT EIN 52-1871508 NONE | Investment advisory (plan) Service code 27 | — | $50K |
| ROGER MCCLOW EIN 36-7485085 TRUSTEE | Trustee (individual) Service code 20 | — | $37K |
| JAY YOUNGDAHL EIN 36-7485085 TRUSTEE | Trustee (individual) Service code 20 | — | $31K |
| O'DONOGHUE & O'DONOGHUE EIN 52-0120528 NONE | Legal Service code 29 | — | $31K |
| BOND BROTHERS EIN 36-2433269 NONE | Copying and duplicating Service code 36 | — | $24K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Claims processing Service code 12 | — | $23K |
| BOLTON PARTNERS, INC. EIN 52-1231144 NONE | Consulting (general); Actuarial Service code 11 | — | $21K |
| EYEMED EIN 86-0773195 NONE | Claims processing Service code 12 | — | $16K |
| MICHAEL BAILEY EIN 36-7485085 TRUSTEE | Trustee (individual) Service code 20 | — | $14K |
| UNITED HEALTHCARE EIN 36-2739571 NONE | Claims processing Service code 12 | — | $12K |
| BRIAN DALEY EIN 36-7485085 TRUSTEE | Trustee (individual) Service code 20 | — | $11K |
| ROGER MINOR EIN 36-7485085 TRUSTEE | Trustee (individual) Service code 20 | — | $10K |
| KEENAN AND ASSOCIATES EIN 95-2798626 NONE | Consulting (general) Service code 16 | — | $8K |
| LASERMARK, INC. NONE | Copying and duplicating Service code 36 | 2945 LONE OAK DRIVE EAGAN, MN 55121 | $6K |
| RONALD KAHN NONE | Other services Service code 49 | 1000 MIDLAND ST LITTLE ROCK, AR 72205 | $5K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,973 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,973 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 4,484 | $2.0M |
| Prescription drug | HUMANA INSURANCE COMPANY | 3,969 | $8.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,484 | — |
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.