| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOCK & BOARDMAN FINANCIAL | PO BOX 1064 BURLINGTON, VT 05402 | CIGNA | $70K | — | $70K | 10.89% |
| HICKOK & BOARDMAN FINANCIAL3 | P.O. BOX 1064 BURLINGTON, VT 05402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 4.53% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN INC. | P.O. BOX 1064 BURLINGTON, VT 05402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 5.92% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FINANCIAL PLANNIN | P.O. BOX 1064 BURLINGTON, VT 05402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $177 | $0 | $177 | 0.15% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FINANCIAL L. | PLANNING AND GROUP BENEFITS INC PO BOX 1064 BURLINGTON, VT 054021064 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.35% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK AND BOARDMAN INC. | P.O. BOX 1064 BURLINGTON, VT 054021064 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | — |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK AND BOARDMAN FINANCIAL PLANN | P.O. BOX 1064 BURLINGTON, VT 05402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $101 | $0 | $101 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Non-monetary compensation; Float revenue; Claims processing; Other services; Contract Administrator; Direct payment from the plan; Participant communication Service code 12 | — | $182K |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 CONTRACT ADMIN. | Contract Administrator Service code 13 | — | $11K |
| NATIONWIDE EIN 31-4125683 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $2K |
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 | 728 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 728 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 232 | $61K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 386 | $204K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 386 | $120K |
| Stop-loss / reinsurancereinsurance | CIGNA | 728 | $646K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 386 | $204K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 728 | — |
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.