| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC. | 100 MERIDIAN CENTRE BLVD. SUITE 100 ROCHESTER, NY 14618 | HCC LIFE INSURANCE COMPANY | — | $4K | $4K | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFETIME BENEFIT SOLUTIONS EIN 16-1171765 TPA | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 115 CONTINUUM DRIVE LIVERPOOL, NY 13088 | $123K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 1087 WAUSAU, WI 54402 | $23K |
| PROACT, INC. EIN 16-1571381 ADMINISTRATION | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 6333 STATE RTE 298 SYRACUSE, NY 13057 | $9K |
| MULTIPLAN INC/PRIVATE HEALTH CARE EIN 13-3068979 ADMINISTRATION | Contract Administrator Service code 13 | PO BOX 29395 NEW YORK, NY 100879395 | $5K |
| HEALTHSMART PREFERRED NETWORK EIN 34-1675523 ADMINISTRATION | Contract Administrator Service code 13 | PO BOX 846038 DALLAS, TX 75284 | $2K |
| OPTUMRX, INC. EIN 33-0441200 CLAIMS PROCESSING | Claims processing; Other fees Service code 12 | PO BOX 2975 MISSION, KS 66201 | $58 |
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 | 353 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 359 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY | 437 | $170K |
| Short-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY | 437 | $170K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY | 437 | $170K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 328 | $224K |
| Other | SUN LIFE AND HEALTH INSURANCE COMPANY | 437 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 437 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.