| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HICKOK & BOARDMAN FINANCIAL Filed as: HICKOK & BOARDMAN | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $139K | — | $139K | 11.00% |
| HICKOK & BOARDMAN FINANCIAL Filed as: HICKOCK & BOARDMAN FINANCIAL PL | 346 SHELBURNE RD BURLINGTON, VT 05401 | UNUM LIFE INSURANCE | $22K | — | $22K | 2.42% |
| PROSENTIAL BENEFITS LLC Filed as: PROSENTIAL GROUP LLC | 40 TIOGA WAY MARBLEHEAD, MA 01945 | UNUM LIFE INSURANCE | — | — | $0 | 0.00% |
| HICKOK & BOARDMAN FINANCIAL Filed as: HICKOCK & BOARDMAN FINANCIAL PL | — | UNUM LIFE INSURANCE | $63K | — | $63K | 14.83% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOCK & BOARDMAN FINANCIAL PL | — | VISION SERVICE PLAN | — | — | $0 | 0.00% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK&BOARDMAN FIN PLNG &GRP 1 | 346 SHELBURNE RD BURLINGTON, VT 05401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 10.87% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK&BOARDMAN FIN PLNG &GRP 1 | 346 SHELBURNE RD BURLINGTON, VT 05401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $337 | — | $337 | 13.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 | Other services; Named fiduciary; Float revenue; Claims processing; Participant communication; Contract Administrator; Direct payment from the plan; Non-monetary compensation Service code 12 | — | $820K |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 | Contract Administrator Service code 13 | — | $28K |
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 | 1,839 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 105 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,944 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 5 | $51K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 5 | $51K |
| Vision | VISION SERVICE PLAN | 1,294 | $181K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE | 1,282 | $1.3M |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE | 1,282 | $897K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 3,054 | $1.3M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE | 1,282 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,054 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.