| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JJAN FINANCIAL5 Filed as: JJAN FINANCIAL GROUP, INC. | 412 ALLEGHENY STREET HOLLIDAYSBURG, PA 16648 | UPMC HEALTH OPTIONS | $715 | — | $715 | 1.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 NONE | Claims processing; Other services Service code 12 | — | $324K |
| CIGNA EIN 06-0303370 NONE | Other services; Participant communication; Direct payment from the plan; Claims processing; Non-monetary compensation; Float revenue; Named fiduciary; Contract Administrator Service code 12 | — | $316K |
| A&I BENEFIT PLAN ADMINISTRATORS NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 1220 SW MORRISON SUITE 300 PORTLAND, OR 97205 | $299K |
| AETNA US HEALTHCARE EIN 06-6033492 NONE | Claims processing Service code 12 | — | $10K |
| CAREMARK NONE | Claims processing Service code 12 | PO BOX 840336 DALLAS, TX 75284 | $6K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,242 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 363 | $588K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.