| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANIELS INSURANCE3 Filed as: DANIELS INSURANCE, INC. | 320 GOLD SW, SUITE 700 ALBUQUERQUE, NM 87102 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $99K | — | $99K | 2.99% |
| UMR, INC.3 Filed as: UMR INC. | 115 WEST WAUSAU AVE WAUSAU, WI 54401 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $633 | — | $633 | 0.02% |
| WEB TPA3 Filed as: WEB-TPA EMPLOYER SERVICES LLC | 8500 FREEPORT PKWY SOUTH IRVING, TX 75063 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BANK OF NEW YORK MELLON EIN 13-5160382 N/A | Custodial (securities); Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 19 | — | $115K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,677 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,677 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 822 | $161K |
| Prescription drug | EXPRESS SCRIPTS, INC. | 1,552 | $1.4M |
| Other | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 1,651 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,651 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.