| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADP INC3 Filed as: AUTOMATIC DATA PROCESSING INSURANCE | 1 ADP BOULEVARD ROSELAND, NJ 07068 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 5.95% |
| ADP INC3 Filed as: AUTOMATIC DATAPROCESSING INSURANCEA | 1 ADP BOULEVARD ROSELAND, NJ 07068 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 7.00% |
| MGIS3 | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $9 | $9 | 0.05% |
| ADP INC3 Filed as: AUTOMATIC DATAPROCESSING INSURANCEA | 1 ADP BOULEVARD ROSELAND, NJ 07068 | SUN LIFE ASSURANCE COMPANY OF CANADA | $741 | — | $741 | 5.00% |
| MGIS3 | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $9 | $9 | 0.06% |
| MGIS3 | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $9 | $9 | 0.07% |
| ADP INC3 Filed as: AUTOMATIC DATAPROCESSING INSURANCE | 1 ADP BOULEVARD ROSELAND, NJ 07068 | SUN LIFE ASSURANCE COMPANY OF CANADA | $181 | — | $181 | 5.00% |
| MGIS3 | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $9 | $9 | 0.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $111K |
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 | 342 | 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. |
| Total participants (= "Plan participants" tile) | 342 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 342 | $56K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 342 | $56K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 250 | $4K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 100 | $13K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 66 | $19K |
| Other(3 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 342 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 342 | — |
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.