| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIDELITY HEALTH INSURANCE SERVICES3 | 20 COMMERCE WAY STE 800 PNC BANK C/O FMR LLC LOCKBOX NUMBER 844303 WOBURN, MA 018011057 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUIST WEALTH EIN 56-1074313 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | PO BOX 4418 MAIL CODE GA-ATL-0219 ATLANTA, GA 303024418 | $211K |
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $194K |
| CUNDY, INC. EIN 59-1089031 ADMINISTRATOR | Contract Administrator Service code 13 | — | $61K |
| TOWERS WATSON EIN 23-1159360 ACTUARY | Actuarial Service code 11 | — | $37K |
| ARMANINO, LLP EIN 94-6214841 AUDITOR | Accounting (including auditing) Service code 10 | — | $22K |
| WAGEWORKS, INC EIN 94-3351864 OTHER | Other services Service code 49 | — | $19K |
| ACCESS INVESTMENT MANAGEMENT | Investment management Service code 28 | 500 UNICORN PARK DRIVE WOBURN, MA 01801 | $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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 549 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 22 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 571 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 544 | $1.8M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 544 | $1.8M |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 258 | $597K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 258 | $597K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 544 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.