| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 32 OLD SLIP FINANCIAL SQUARE NEW YORK, NY 100053500 | METROPOLITAN LIFE INSURANCE COMPANY | — | $111 | $111 | 0.03% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 5444 WESTHEIMER RD STE 900 HOUSTON, TX 77056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $3K | $10K | 14.21% |
| PARK BENEFITS & ENROLLMENT LLC3 | 504 LITCHFIELD LN LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 7.68% |
| DAVID J MCCLELLAN3 | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $875 | $2K | $3K | 3.72% |
| MAGDA ISABEL WISDOM3 | 2453 WILLOW PARK RD BETHLEHEM, PA 18020 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $936 | — | $936 | 1.35% |
| HELEN DIZ-HATTON3 | 4 PALMER LN ENGLISHTOWN, NJ 07726 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $616 | — | $616 | 0.89% |
| CLARICE R MIMS3 | 133 HILLCREST DRIVE MARLBORO, NY 12542 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $229 | $9 | $238 | 0.34% |
| JENNIFER MCCLELLAN3 | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $31 | $50 | 0.07% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $25 | $36 | 0.05% |
| WALTER THOMAS BONILLA3 | 9 LONGLEAF LN MEDFORD, NY 11763 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.02% |
| NATIONAL ENROLLMENT PARTNERS LLC3 | C/O NATL ENROLLMENT PARTNERS CRANSTON, RI 02920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS COMPANY EIN 59-1031071 CONTRACT ADMINISTRATOR | Other services; Participant communication; Non-monetary compensation; Claims processing; Contract Administrator; Float revenue; Named fiduciary; Direct payment from the plan Service code 12 | — | $388K |
| MULTIPLAN, INC EIN 13-3068979 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $6K |
| CIGNA | Float revenue; Non-monetary compensation; Claims processing; Named fiduciary; Direct payment from the plan; Participant communication; Other services; Contract Administrator Service code 12 | — | $0 |
| METROPOLITAN LIFE INS COMPANY EIN 13-5581829 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $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 | 981 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 989 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 780 | $1.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 780 | $1.4M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 780 | $1.4M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 880 | $348K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 880 | $348K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 880 | $348K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 780 | $1.5M |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 880 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 880 | — |
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.