| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 Filed as: AON CONSULTING | 1900 SIXTEENTH STREET DENVER, CO 80202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $19K | $19K | 0.66% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $17K | $17K | 0.59% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | SECURIAN LIFE INSURANCE COMPANY | $0 | $33K | $33K | 1.30% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | PO BOX 6718 SOMERSET, NJ 08875 | METROPOLITAN LIFE INSURANCE COMPANY | $28K | $4K | $31K | 9.00% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $1K | $15K | 4.22% |
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | METROPOLITAN LIFE INSURANCE COMPANY | $161 | $27 | $188 | 0.05% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | PO BOX 419623 BOSTON, MA 02241 | METLIFE LEGAL PLANS | $11K | $181 | $11K | 6.02% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | METLIFE LEGAL PLANS | $8K | $0 | $8K | 4.14% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | METLIFE LEGAL PLANS | $0 | $2K | $2K | 0.87% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $0 | $2K | 21.33% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | FIRST UNUM LIFE INSURANCE COMPANY | $79 | $0 | $79 | 0.92% |
No Schedule C service providers reported on this filing.
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 | 4,548 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 43 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,591 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 205 | $1.5M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF COLORADO | 8,716 | $2.8M |
| Vision | VISION SERVICE PLAN | 3,209 | $588K |
| Life insurance(2 contracts, 2 carriers) | SECURIAN LIFE INSURANCE COMPANY | 4,548 | $2.6M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,869 | $2.9M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 91 | $441K |
| Other(5 contracts, 5 carriers) | SECURIAN LIFE INSURANCE COMPANY | 4,548 | $3.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,716 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.