| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHILD HEALTH CORPORATION OF AMERICA3 | 6803 WEST 64TH ST, SUITE 208 SHAWNEE MISSION, KS 66202 | HARTFORD LIFE AND ACCIDENT | $325K | $160K | $485K | 9.99% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | — | $132K | $132K | 2.71% |
| CHILD HEALTH CORPORATION OF AMERICA3 | 6803 WEST 64TH ST, SUITE 208 SHAWNEE MISSION, KS 66202 | HARTFORD LIFE AND ACCIDENT | $13K | $4K | $16K | 10.17% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | — | $5K | $5K | 3.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVE. HARTFORD, CT 06156 | $3.3M |
| SPECTERA, INC. EIN 52-1260282 CONTRACT ADMIN/BROKER | Contract Administrator; Other commissions Service code 13 | 6220 OLD DOBBIN LANE COLUMBIA, MD 21045 | $517K |
| CVS PHARMACY INC. EIN 05-0340626 CLAIMS PROCESSING | Claims processing Service code 12 | ONE CVS DRIVE WOONSOCKET, RI 02895 | $29K |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL INSURANCE COMPANY | 0 | $4.0M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 0 | $4.9M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 0 | $4.9M |
| Other | HARTFORD LIFE AND ACCIDENT | 0 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.