| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDWARD JOSEPH CHICOSKI3 | 529 MAIN STREET SUITE 2B NEW HARTFORD, CT 06057 | AETNA | $12K | — | $12K | 3.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES EIN 35-0781558 NONE | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Contract Administrator Service code 12 | — | $470K |
| MILLIMAN, INC EIN 91-0675641 NONE | Actuarial Service code 11 | — | $280K |
| CARDAY AND ASSOCIATES NONE | Contract Administrator Service code 13 | 7130 COLUMBIA GATEWAY DR SUITE A COLUMBIA, MD 21046 | $113K |
| SLEVIN AND HART EIN 52-1708613 NONE | Legal Service code 29 | — | $111K |
| REINHART, BOERNER, VAN DEUREN EIN 39-1126909 NONE | Legal Service code 29 | — | $107K |
| TIC INTERNATIONAL EIN 13-2600875 NONE | Consulting (general) Service code 16 | — | $92K |
| NANCY DUFF EIN 55-0393244 NONE | Employee (plan) Service code 30 | — | $36K |
| PATRICIA PETTRY EIN 55-0393244 NONE | Employee (plan) Service code 30 | — | $35K |
| CAROLE BEALS EIN 55-0393244 NONE | Employee (plan) Service code 30 | — | $33K |
| KIMBERLY ROGERS EIN 55-0393244 NONE | Employee (plan) Service code 30 | — | $32K |
| APRIL SMITH EIN 55-0393244 NONE | Employee (plan) Service code 30 | — | $31K |
| ADAM THORNBURG EIN 55-0393244 NONE | Employee (plan) Service code 30 | — | $30K |
| DENNIS G. JENKINS,CPA, LLC EIN 20-5886120 NONE | Accounting (including auditing) Service code 10 | — | $29K |
| NEPC CONSULTANT | Consulting fees Service code 70 | 400 GALLERIA PARKWAY SUITE 1960 ATLANTA, GA 30339 | $26K |
| UNITED ACTUARIAL EIN 35-2156428 NONE | Actuarial Service code 11 | — | $9K |
| KPP PRESCRIPTION BENEFITS | Other fees Service code 99 | PO BOX 677551 DALLAS, TX 752677551 | $8K |
| KAREN WORKMAN EIN 55-0393244 NONE | Employee (plan) Service code 30 | — | $6K |
| ELIZABETH GUNNOE EIN 55-0393244 NONE | Employee (plan) Service code 30 | — | $6K |
| SONJA STONESTREET EIN 55-0393244 NONE | Employee (plan) Service code 30 | — | $6K |
| CONIFER VALUE-BASED CARE, LLC NONE | Participant communication Service code 38 | 1596 WHITEHALL RD. ANNAPOLIS, MD 21409 | $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 | 1,744 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 575 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,319 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AETNA | 3,080 | $336K |
| Stop-loss / reinsurancereinsurance | AIG BENEFIT SOLUTIONS | 2,031 | $290K |
| Other | AETNA | 3,080 | $336K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,080 | — |
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."
No prospect flags tripped on this filing.