| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFIT PROGRAMS INC. DBA | UNIVERS WORKPLACE 897 12TH ST HAMMONTON, NJ 08037 | AETNA LIFE INSURANCE CO. | $603K | — | $603K | 26.63% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MATRIX ABSENCE MANAGEMENT, INC. EIN 77-0493584 NONE | Claims processing Service code 12 | — | $133K |
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 | 23,482 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 23,482 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 1,105 | $14.0M |
| Dental(2 contracts) | DELTA DENTAL INSURANCE COMPANY | 18,163 | $7.3M |
| Vision | EYEMED VISION CARE | 17,988 | $921K |
| Life insurance(2 contracts, 2 carriers) | SECURIAN LIFE INSURANCE COMPANY | 26,286 | $5.0M |
| Short-term disability | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 286 | $59K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 5,021 | $1.2M |
| Prescription drug(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 1,105 | $14.0M |
| Other(2 contracts, 2 carriers) | SECURIAN LIFE INSURANCE COMPANY | 26,286 | $5.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 68,323 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.