| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS AND3 | COMPENSATION SYSTEMS INC 101 PARK AVE FL 14 NEW YORK, NY 101782103 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 2.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TEAMSTERS RX EIN 02-6015031 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $420K |
| CIGNA ADMIN EXPENSE EIN 59-1031071 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $247K |
| PAYFLEX SYSTEMS USA, INC. EIN 91-1774434 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $9K |
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 | 4,914 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 315 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 0 | $4K |
| Dental | DELTA DENTAL OF MISSOURI | 3 | $4K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,363 | $55K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 2,363 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,363 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.