| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARVARD PRINTING GROUP5 | 175 US HIGHWAY 46 WEST FAIRFIELD, NJ 070042327 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $693 | $693 | 2.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONNECTICUT GENERAL LIFE INS. CO. EIN 59-1031071 ADMINISTRATIVE SERVICES | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator Service code 12 | — | $1.4M |
| PRUDENTIAL INSURANCE CO. OF AMERICA EIN 22-1211670 ADMINISTRATIVE SERVICES | Contract Administrator Service code 13 | — | $37K |
| CIGNA | Contract Administrator; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $0 |
| COMPPSYCH EIN 35-3739783 ADMINISTRATIVE SERVICES | Contract Administrator Service code 13 | — | $0 |
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 | 1,535 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 100 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,635 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CONNECTICUT GENERAL LIFE INSURANCE COMPANY | 3,650 | $1.4M |
| Dental | CONNECTICUT GENERAL LIFE INSURANCE COMPANY | 3,650 | $1.4M |
| Vision | VISION SERVICE PLAN | 1,036 | $451K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 545 | $336K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,491 | $492K |
| Stop-loss / reinsurancereinsurance | CONNECTICUT GENERAL LIFE INSURANCE COMPANY | 3,650 | $1.4M |
| Other(8 contracts, 3 carriers) | CONNECTICUT GENERAL LIFE INSURANCE COMPANY | 3,650 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,650 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.