| 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 | — | $59 | $59 | 0.02% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 2000 WEST LOOP SOUTH HOUSTON, TX 77027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $5K | $17K | 17.40% |
| PARK BENEFITS & ENROLLMENT LLC3 | 504 LITCHFIELD LN LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $3K | $7K | 7.48% |
| HELEN DIZ-HATTON3 | 4 PALMER LN ENGLISHTOWN, NJ 07726 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 4.48% |
| DAVID J MCCLELLAN3 | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $851 | $2K | $3K | 2.80% |
| MAGDA ISABEL WISDOM3 | 2453 WILLOW PARK RD BETHLEHEM, PA 18020 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.14% |
| CLARICE R MIMS3 | 17290 HIGHLAND AVE APT 2B JAMAICA, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $126 | $1K | 1.32% |
| CRYSTAL IBC LLC3 | 1 FINANCIAL SQ FL 32 NEW YORK, NY 10005 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $824 | — | $824 | 0.84% |
| WALTER THOMAS BONILLA3 | 9 LONGLEAF LN MEDFORD, NY 11763 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 0.05% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $4 | $9 | 0.01% |
| BARUCH KLAHR3 | 100 DUTCH HILL RD. ORANGEBURG, NY 10962 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JASON LOUIS KOSCO3 | 481 RYCOLA CIRCLE SURFSIDE BEACH, SC 29575 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| MCCAREY INC3 | 6320 GREENHAVEN DR CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| SATS LLC3 | 77 SPRUCE ST CEDARHURST, NY 11516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| SOTERIA PARTNERS LLC3 | 4 CENTURY DRIVE PARSIPPANY, NJ 07054 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS COMPANY EIN 59-1031071 CONTRACT ADMINISTRATOR | Contract Administrator; Non-monetary compensation; Other services; Float revenue; Direct payment from the plan; Participant communication; Named fiduciary; Claims processing Service code 12 | — | $504K |
| METROPOLITAN LIFE INS COMPANY EIN 13-5581829 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $33K |
| MULTIPLAN, INC EIN 13-3068979 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $13K |
| CIGNA | Named fiduciary; Float revenue; Contract Administrator; Other services; Participant communication; Direct payment from the plan; Claims processing; Non-monetary compensation 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 | 1,016 | 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) | 1,024 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 722 | $1.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 722 | $1.5M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 722 | $1.5M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,165 | $389K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,165 | $389K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,165 | $389K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 722 | $1.7M |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,165 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,165 | — |
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.