| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTINE ANDREWS3 | 4 FOREST PARK DR. FARMINGTON, CT 06032 | HORIZON HEALTHCARE SERVICES, INC. | $57K | — | $57K | 1.61% |
| HILB GROUP OF NEW ENGLAND3 | 6802 PARAGON PLACE, STE. 200 RICHMOND, VA 23230 | HORIZON HEALTHCARE SERVICES, INC. | $28K | — | $28K | 0.80% |
| CHRISTINE ANDREWS3 | 4 FOREST PARK DR. FARMINGTON, CT 06032 | HORIZON HEALTHCARE SERVICES, INC. | $5K | — | $5K | 1.63% |
| HILB GROUP OF NEW ENGLAND3 | 6802 PARAGON PLACE, STE. 200 RICHMOND, VA 23230 | HORIZON HEALTHCARE SERVICES, INC. | $2K | — | $2K | 0.77% |
| CHRISTINE ANDREWS3 | 4 FOREST PARK DR. FARMINGTON, CT 06032 | HORIZON HEALTHCARE SERVICES, INC. | $5K | — | $5K | 2.43% |
| HILB GROUP OF NEW ENGLAND3 | 6802 PARAGON PLACE, STE. 200 RICHMOND, VA 23230 | HORIZON HEALTHCARE SERVICES, INC. | $1K | — | $1K | 0.65% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N 40TH ST., STE. 234 PHOENIX, AZ 85018 | LIFE INSURANCE OF NORTH AMERICA | — | $4K | $4K | 4.46% |
| CHRISTINE ANDREWS3 | PO BOX 466 FARMINGTON, CT 06034 | LIFE INSURANCE OF NORTH AMERICA | $3K | — | $3K | 3.37% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 6.82% |
| CHRISTINE ANDREWS3 | 4 FOREST PARK DR. FARMINGTON, CT 06032 | AMERITAS LIFE INSURANCE CORP. | $1K | — | $1K | 3.19% |
| CHRISTINE ANDREWS3 | PO BOX 466 FARMINGTON, CT 06034 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $691 | — | $691 | 3.87% |
| HILB GROUP OF NEW ENGLAND3 | PO BOX 466 FARMINGTON, CT 06034 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $201 | — | $201 | 1.13% |
| CHRISTINE ANDREWS3 | PO BOX 466 FARMINGTON, CT 06034 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 9.53% |
| CHRISTINE ANDREWS3 | 4 FOREST PARK DR. FARMINGTON, CT 06032 | HORIZON HEALTHCARE DENTAL, INC. | $318 | — | $318 | 2.43% |
| HILB GROUP OF NEW ENGLAND3 | 6802 PARAGON PLACE, STE. 200 RICHMOND, VA 23230 | HORIZON HEALTHCARE DENTAL, INC. | $85 | — | $85 | 0.65% |
| CHRISTINE ANDREWS3 | PO BOX 466 FARMINGTON, CT 06034 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.69% |
| LIDAC EMPLOYEE BENEFIT SOLUTIONS3 | 1010 NORTHERN BLVD. #324 GREAT NECK, NY 11021 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $552 | $552 | 5.00% |
| HILB GROUP OF NEW ENGLAND3 | PO BOX 466 FARMINGTON, CT 06034 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $476 | — | $476 | 4.31% |
| CHRISTINE ANDREWS3 | PO BOX 466 FARMINGTON, CT 06034 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 125.97% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N 40TH ST., STE. 234 PHOENIX, AZ 85018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$78 | $2K | $2K | 75.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 CLAIMS ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $31K |
| HILB GROUP OF NEW ENGLAND LLC BENEFIT ADVISOR | Insurance agents and brokers Service code 22 | 4 FOREST PARK DR. FARMINGTON, CT 06032 | $0 |
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 | 512 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 518 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 278 | $3.5M |
| Dental(3 contracts, 3 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 219 | $247K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 574 | $36K |
| Life insurance | LIFE INSURANCE OF NORTH AMERICA | 512 | $95K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 20 | $18K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 278 | $295K |
| Other(4 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 512 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 574 | — |
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.