| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | 3500 LENOX ROAD, SUITE 1600 ATLANTA, GA 30326 | AETNA LIFE INSURANCE CO | $20K | — | $20K | 2.23% |
| HUNTINGTON INSURANCE INC3 | 221 S CHURCH ST BOWLING GREEN, OH 43402 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $14K | $14K | 3.28% |
| CONDUENT HR CONSULTING LLC3 Filed as: CONDUENT HR CONSULTING, LLC | PO BOX 202617 DALLAS, TX 753202617 | VISION SERVICE PLAN | $15K | — | $15K | 5.00% |
| AON CONSULTING INC3 | 199 WATER STREET NEW YORK, NY 10038 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $3K | — | $3K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NC EIN 56-0894904 CLAIMS PROCESSING | Claims processing Service code 12 | — | $813K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Non-monetary compensation; Other services; Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Participant communication; Float revenue Service code 12 | — | $372K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $233K |
| SEDGWICK CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 171816 MEMPHIS, TN 381871865 | $151K |
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 | 1,767 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 52 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,832 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 2 | $30K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,254 | $329K |
| Life insurance | AETNA LIFE INSURANCE CO | 1,770 | $915K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,214 | $417K |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO | 1,770 | $946K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,770 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.