| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $42K | $42K | 1.25% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $35K | $2K | $38K | 13.74% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 1 NORTH WHITE HORSE PIKE, SUITE 2 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25K | $4K | $29K | 10.54% |
| ASSUREX3 | 175 SOUTH 3RD STREET, SUITE 800 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $2K | $2K | 0.75% |
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IL 46082 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $114 | $15K | 5.66% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $10K | $10K | 3.82% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | PO BOX 6718 SOMERSET, NJ 08875 | METROPOLITAN LIFE INSURANCE COMPANY | -$179K | $3K | -$176K | -67.25% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | METLIFE LEGAL PLANS | $19K | $625 | $19K | 10.32% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | METLIFE LEGAL PLANS | $0 | $480 | $480 | 0.26% |
| MJ INSURANCE3 | 350 NORTH ORLEANS STREET SUITE 1746 CHICAGO, IL 60654 | METLIFE LEGAL PLANS | $0 | $34 | $34 | 0.02% |
| UNKNOWN3 | UNKNOWN GREENWOOD VILLAGE, CO 80111 | FOUR EVER LIFE INSURANCE COMPANY | $4K | $383 | $4K | 11.54% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $0 | $2K | 22.82% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 1 NORTH WHITE HORSE PIKE, SUITE 2 HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $909 | $0 | $909 | 10.03% |
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 | 4,555 | 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) | 4,555 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 209 | $2.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF COLORADO | 8,605 | $2.8M |
| Vision(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 3,186 | $2.7M |
| Life insurance(2 contracts, 2 carriers) | SECURIAN LIFE INSURANCE COMPANY | 4,555 | $2.9M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,565 | $3.3M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 105 | $582K |
| Other(7 contracts, 7 carriers) | SECURIAN LIFE INSURANCE COMPANY | 4,555 | $3.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,605 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.