| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC. | PO BOX 95287 CHICAGO, IL 60694 | HCC LIFE INSURANCE COMPANY | $8K | — | $8K | 3.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 1087 WAUSAU, WI 54402 | $141K |
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT | Direct payment from the plan; Claims processing; Float revenue; Other fees Service code 12 | PO BOX 2975 MISSION, KS 66201 | $256 |
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 | 305 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 305 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 289 | $151K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 289 | $151K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 259 | $237K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 490 | $158K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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."
No prospect flags tripped on this filing.