| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TEXAS HWY S #2-600 AUSTIN, TX 78746 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $29K | $0 | $29K | 4.60% |
| IMG5 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $221 | $221 | 0.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST ADMINISTRATORS ADMIN | Claims processing Service code 12 | 1501 SOUTH CLINTON STREET BALTIMORE, MD 21224 | $289K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $109K |
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 ADMIN | Claims processing Service code 12 | — | $50K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $33K |
| PRUDENTIAL INSURANCE COMPANY OF AME EIN 22-1211670 ADMIN | Claims processing Service code 12 | — | $28K |
| COMPSYCH EIN 35-3739783 ADMIN | Claims processing Service code 12 | — | $12K |
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 | 1,058 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,067 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,176 | $82K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,058 | $638K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,058 | $638K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,058 | $638K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 728 | $1.4M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,058 | $638K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,176 | — |
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.