| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | SUNLIFE ASSURANCE COMPANY OF CANADA | $18K | $54K | $72K | 6.36% |
| UMR, INC.3 | 11 SCOTT ST STE 100 WAUSUA, WI 54403 | SUNLIFE ASSURANCE COMPANY OF CANADA | $0 | $7K | $7K | 0.64% |
| CHILD HEALTH CORPORATION OF AMERICA3 | 16011 COLLEGE BLVD STE 250 LENEXA, KS 66219 | SUNLIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 0.13% |
| CHILD HEALTH CORPORATION OF AMERICA3 | 16011 COLLEGE BLVD SUITE 250 LENEXA, KS 66219 | UNITED HEALTH CARE INSURANCE COMPANY | $43K | — | $43K | 8.70% |
| CHILD HEALTH CORP OF AMERICA3 | 16011 COLLEGE BLVD STE 250 LENEXA, KS 66219 | HARTFORD LIFE AND ACCIDENT | $79K | $15K | $95K | 22.65% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | $31K | — | $31K | 7.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS ADMINISTRATION | Claims processing Service code 12 | 115 W WAUSAU AVE WAUSAU, WI 54401 | $1.4M |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMINISTRATION | Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services Service code 12 | 525 WEST MONROE STREET SUITE 300 CHICAGO, IL 60661 | $187K |
| THE BENEFITS SERVICES GROUP EIN 39-1593551 NONE | Consulting (general) Service code 16 | N25W23050 PAUL ROAD PEWAUKEE, WI 53072 | $25K |
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 | 4,932 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,932 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITED HEALTH CARE INSURANCE COMPANY | 2,988 | $498K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 4,932 | $418K |
| Stop-loss / reinsurancereinsurance | SUNLIFE ASSURANCE COMPANY OF CANADA | 3,717 | $1.1M |
| Other | ACE AMERICAN INSURANCE COMPANY | 4,030 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,932 | — |
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.