| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE PARTNERS GROUP3 Filed as: TPG GROUP INC | 10 TOWER LANE SUITE 100 AVON, CT 06001 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $926 | — | $926 | 0.02% |
| WEB TPA3 Filed as: WEB-TPA EMPLOYER SERVICES LLC | 8500 FREEPORT PKWY SOUTH IRVING, TX 75063 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $914 | — | $914 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BANK OF NEW YORK MELLON EIN 13-5160382 N/A | Trustee (bank, trust company, or similar financial institution); Custodial (other than securities); Direct payment from the plan; Custodial (securities) Service code 18 | — | $50K |
| MILLIMAN N/A | Account maintenance fees; Direct payment from the plan Service code 50 | 1301 FIFTH AVE STE 3800 SEATTLE, WA 98101 | $22K |
| TOWERS WATSON EIN 25-1159360 N/A | Direct payment from the plan; Actuarial; Account maintenance fees Service code 11 | — | $8K |
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 | 1,955 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,955 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 875 | $175K |
| Prescription drug | EXPRESS SCRIPTS, INC. | 1,817 | $2.1M |
| Other | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 1,827 | $4.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,827 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.