| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFIT ADMINISTRATORS OF CT3 | 37 BROADWAY, 2ND FLOOR NORTH HAVEN, CT 06473 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $87 | $78K | $78K | 5.00% |
| GROUP BENEFIT ADMINISTRATORS OF CT3 | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | HUMANA INSURANCE COMPANY | $29K | — | $29K | 3.27% |
| COPPOLA, MICHAEL J3 | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | HUMANA INSURANCE COMPANY | $15K | — | $15K | 1.73% |
| GROUP BENEFIT ADMINISTRATORS OF CT3 | 37 BROADWAY, 2ND FLOOR NORTH HAVEN, CT 06473 | ANTHEM HEALTH PLANS OF CONNECTICUT, INC. | $8K | — | $8K | 5.00% |
| GROUP BENEFIT ADMINISTRATORS OF CT3 | 37 BROADWAY, 2ND FLOOR NORTH HAVEN, CT 06473 | ANTHEM LIFE INSURANCE COMPANY | $9K | — | $9K | 9.47% |
| GROUP BENEFIT ADMINISTRATORS OF CT3 | 23 MAIDEN LANE, SUITE 2 NORTH HAVEN, CT 05473 | EYEMED VISION CARE | $3K | — | $3K | 10.08% |
| GROUP BENEFIT ADMINISTRATORS OF CT3 | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | MUTUAL OF OMAHA INSURANCE COMPANY | $150 | — | $150 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM LIFE INSURANCE COMPANY EIN 35-0980405 NONE | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $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 | 327 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 327 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 99 | $2.4M |
| Dental | ANTHEM HEALTH PLANS OF CONNECTICUT, INC. | 175 | $168K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 327 | $1.6M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 201 | $93K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 201 | $93K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 209 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 327 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.