| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HICKOK & BOARDMAN FINANCIAL3 | 346 SHELBURNE ROAD BURLINGTON, VT 05401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $46K | — | $46K | 9.17% |
| HICKOK & BOARDMAN FINANCIAL | 346 SHELBURNE ROAD BURLINGTON, VT 05401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $10K | 8.76% |
| HICKOK & BOARDMAN FINANCIAL | 346 SHELBURNE ROAD BURLINGTON, VT 05401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $591 | $6K | 16.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 NONE | Non-monetary compensation; Float revenue; Participant communication; Direct payment from the plan; Named fiduciary; Claims processing; Contract Administrator; Other services Service code 12 | — | $153K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 NONE | Float revenue; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Other services; Contract Administrator Service code 12 | — | $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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 149 | $119K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 149 | $119K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 400 | $502K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 149 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 400 | — |
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.