| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 701 B ST FL 6 ATTN JAMES PEDERSON SAN DIEGO, CA 921018156 | METROPOLITAN LIFE INSURANCE COMPANY | $137K | $71 | $137K | 2.77% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 701 B STR, FL 6 ATTN JAMES PEDERSON SAN DIEGO, CA 921018156 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $39K | $39K | 0.78% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST FL 6 SAN DIEGO, CA 921018156 | KAISER FOUNDATION HEALTH PLAN INC. | $97K | $0 | $97K | 2.50% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT EMPLOYEE BENEFITS | 1120 SANCTUARY PKWY, STE 300 ALPHARETTA, GA 30009 | ZURICH AMERICAN INSURANCE CO | $60K | — | $60K | 5.50% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1120 SANCTUARY PKWY, STE 300 ALPHARETTA, GA 300097631 | VISION SERVICE PLAN | $12K | — | $12K | 2.94% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B ST FL 6 SAN DIEGO, CA 921018156 | VISION SERVICE PLAN | $9K | — | $9K | 2.06% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFIT LLC | 1166 AVE OF AMERICAS 22F NEW YORK, NY 10036 | FEDERAL INSURANCE COMPANY | $0 | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $2.3M |
| CVS CAREMARK EIN 05-0340626 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $132K |
| AETNA BEHAVIORAL HEALTH, LLC PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $88K |
| DISCOVERY BENEFITS EIN 90-0058554 FSA ADMINISTRATOR | Contract Administrator Service code 13 | — | $88K |
| HEALTH AND HUMAN RES. CENTER, INC EIN 33-0052273 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $19K |
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 | 5,146 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 45 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 979 | $3.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 12,303 | $5.0M |
| Vision | VISION SERVICE PLAN | 3,702 | $419K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 12,303 | $5.0M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 12,303 | $5.0M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 979 | $3.9M |
| Stop-loss / reinsurancereinsurance | ZURICH AMERICAN INSURANCE CO | 3,657 | $1.1M |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 12,303 | $5.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,303 | — |
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.