| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 100 FRONT ST SUITE 800 WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $958 | $958 | 0.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 NONE | Other fees; Contract Administrator; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $748K |
| MERITAIN HEALTH EIN 16-1264154 NONE | Other services; Contract Administrator; Participant communication; Claims processing Service code 12 | — | $699K |
| JUDITH MITCHELL EIN 43-0681778 EMPLOYEE/ADMINISTRATOR | Plan Administrator; Employee (plan) Service code 14 | — | $159K |
| MARY BETH CYLIAX EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $131K |
| JOANNA CLAYTON EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $105K |
| DIANE ROSSO EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $104K |
| LYNNE SCHREIBER EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $103K |
| CYNTHIA FOSTER EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $93K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Contract Administrator; Claims processing Service code 12 | — | $77K |
| PATRICIA WARREN EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $68K |
| PREFERRED RESOURCE NETWORK INC EIN 43-1613278 NONE | Other services Service code 49 | — | $67K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $66K |
| JOANNA HAM EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $65K |
| CATHERINE DOBRYNSKI EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $61K |
| EVELYN DUNAJCIK EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| SCHUCHAT, COOK & WERNER EIN 43-0763010 NONE | Legal Service code 29 | — | $55K |
| ROCKWOOD CAPITAL ADVISORS EIN 43-1775815 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $55K |
| MARSH & MCLENNAN EIN 26-3237576 NONE | Consulting (general) Service code 16 | — | $51K |
| SYSTEMS DESIGN ASSOCIATES EIN 43-1228887 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $43K |
| AMY JO WOOD EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| AMWINS GROUP BENEFITS LLC EIN 05-0461576 NONE | Claims processing; Contract Administrator Service code 12 | — | $37K |
| JULIE KOONTZ EIN 43-0681778 EMPLOYEE | Employee (plan) Service code 30 | — | $35K |
| BYRNE SOFTWARE TECHNOLOGIES, INC EIN 43-1853340 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $34K |
| CONNER ASH PC EIN 43-1012822 NONE | Accounting (including auditing) Service code 10 | — | $30K |
| ASMED HEALTH, LLC EIN 27-4189010 NONE | Other services Service code 49 | — | $29K |
| MARQUETTE ASSOCIATES EIN 36-3485298 NONE | Investment advisory (plan) Service code 27 | — | $13K |
| NETTECH, INC. EIN 43-1712583 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 15 | — | $13K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Float revenue; Soft dollars commissions; Custodial (securities) Service code 19 | — | $12K |
| EKON BENEFITS EIN 43-1317863 NONE | Actuarial Service code 11 | — | $12K |
| CHANGE HEALTH CARE EIN 20-5799664 NONE | Claims processing Service code 12 | — | $9K |
| WEB CONNECTIVITY LLC EIN 35-2070190 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $8K |
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 | 1,327 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 178 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,505 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 770 | $2.0M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 3,848 | $151K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,742 | $589K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 3,848 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,848 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.