| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS & COMP SYS INC | 101 PARK AVE 14TH FLOOR NEW YORK, NY 10178 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $21K | — | $21K | 1.32% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GRP LLC | DBA IBX 1125 SANCTUARY PKWY SUITE 300 ALPHARETTA, GA 30009 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 0.95% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $217 | $217 | 0.01% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 300097614 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $55 | $20K | 2.15% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 5444 WESTHEIMER RD STE 900 HOUSTON, TX 770565306 | METROPOLITAN LIFE INSURANCE COMPANY | — | $15K | $15K | 1.59% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GROUP,LLC | PO BOX 675236 DETROIT, MI 482675236 | HCC LIFE INSURANCE COMPANY | $13K | — | $13K | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 PLAN ADMINISTRATOR | Participant communication; Other services; Contract Administrator; Non-monetary compensation; Named fiduciary; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $505K |
| BLUE CROSS BLUE SHIELD OF FLORIDA EIN 59-2015694 ASO FEES | Contract Administrator Service code 13 | — | $99K |
| AETNA BEHAVIORAL HEALTH, LLC PLAN ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINTON AVENUE RSAA HARTFORD, CT 06156 | $22K |
| COMPSYCH EIN 35-3739783 TPA FEES | Contract Administrator Service code 13 | — | $15K |
| HEALTH & HUMAN RESOURCE CENTER INC. PLAN ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $1K |
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 | 1,340 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,355 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF FLORIDA | 1,444 | $2.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,120 | $944K |
| Vision(2 contracts) | EYEMED VISION CARE | 983 | $145K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,386 | $2.5M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,386 | $1.6M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,134 | $221K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,444 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,444 | — |
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.