| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDWARD JOSEPH CHICOSKI | 301 ALBANY TURNPIKE CANTON, CT 06019 | AETNA LIFE INSURANCE CO. | $65 | — | $65 | 0.02% |
| EDWARD JOSEPH CHICOSKI | 529 MAIN STREET, SUITE 2B NEW HARTFORD, CT 60657 | AETNA LIFE INSURANCE CO. | $35 | — | $35 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $544K |
| ANTHEM INSURANCE COMPANIES EIN 35-0781558 NONE | Contract Administrator; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $506K |
| ANTHEM HEALTH PLANS OF VIRGINIA INC EIN 54-0357120 NONE | Float revenue; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $454K |
| CONIFER VALUE-BASED CARE, LLC EIN 52-1964905 NONE | Other fees Service code 99 | — | $445K |
| CARDAY AND ASSOCIATES NONE | Plan Administrator Service code 14 | 7130 COLUMBIA GATEWAY DR, SUITE A COLUMBIA, MD 21046 | $251K |
| MILLIMAN INC. EIN 91-0675641 NONE | Actuarial; Consulting (general) Service code 11 | — | $249K |
| SLEVIN & HART, P.C. EIN 52-1708613 NONE | Legal Service code 29 | — | $128K |
| REINHART, BOERNER, VAN DEUREN EIN 39-1126909 NONE | Legal Service code 29 | — | $128K |
| CAROLE BEALS EIN 55-0393244 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| NANCY DUFF EIN 55-0393244 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| KIMBERLY ROGERS EIN 55-0393244 EMPLOYEE | Employee (plan) Service code 30 | — | $44K |
| APRIL SMITH EIN 55-0393244 EMPLOYEE | Employee (plan) Service code 30 | — | $40K |
| KAREN WORKMAN EIN 55-0393244 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| PATRICIA PETTRY EIN 55-0393244 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $37K |
| ELIZABETH GUNNOE EIN 55-0393244 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| DEANN CARPENTER EIN 55-0393244 EMPLOYEE | Employee (plan) Service code 30 | — | $30K |
| NEPC, LLC NONE | Investment advisory (plan) Service code 27 | 400 GALLERIA PARKWAY, SUITE 1960 ATLANTA, GA 30339 | $25K |
| KPP NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | P.O. BOX 677551 DALLAS, TX 75267 | $15K |
| UNITED ACTUARIAL EIN 35-2156428 NONE | Actuarial Service code 11 | — | $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 | 1,848 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 565 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,413 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 7,555 | $544K |
| Other | AETNA LIFE INSURANCE CO. | 3,416 | $282K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,555 | — |
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.