| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UMR, INC.3 Filed as: UMR | 5151 PHEIFFER RD ML 400 PHEIFFER WOODS, OH 45242 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 0.66% |
| CHILD HEALTH CORPORATION OF AMERICA3 | 16011 COLLEGE BLVD SUITE 250 LENEXA, KS 66219 | UNITED HEALTH CARE INSURANCE COMPANY | $21K | — | $21K | 4.43% |
| CHILD HEALTH CORP OF AMERICA3 | 16011 COLLEGE BLVD. STE 250 LENEXA, KS 66219 | HARTFORD LIFE AND ACCIDENT | $71K | $8K | $79K | 21.82% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | — | $28K | $28K | 7.84% |
| OCEAN CONSULTING GROUP Filed as: OCEAN CONSULTING GROUP INC. | 160 EILEEN WAY SYOSSET, NY 11803 | ACE AMERICAN INSURANCE COMPANY | $5K | — | $5K | 30.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 115 W WAUSAU AVE WAUSAU, WI 54401 | $1.2M |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 NONE | Float revenue; Participant communication; Direct payment from the plan; Other services; Named fiduciary; Contract Administrator; Claims processing; Non-monetary compensation Service code 12 | 525 WEST MONROE STREET SUITE 300 CHICAGO, IL 60661 | $178K |
| THE BENEFITS SERVICE GROUP EIN 39-1593551 NONE | Consulting (general) Service code 16 | N25W23050 PAUL ROAD PEWAUKEE, WI 53072 | $30K |
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 | 4,651 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,651 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITED HEALTH CARE INSURANCE COMPANY | 2,746 | $470K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 4,651 | $360K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,487 | $584K |
| Other | ACE AMERICAN INSURANCE COMPANY | 4,030 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,651 | — |
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.