| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | CIGNA HEALTH AND LIFE COMPANY | $45K | — | $45K | 9.09% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $378 | $5K | 9.67% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $275 | $6K | 15.75% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | FIDELITY SECURITY LIFE | $3K | — | $3K | 8.95% |
| FRED C. CHURCH INC.3 Filed as: FRED C CHURCH INC. | 41 WELLMAN STREET LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $942 | $71 | $1K | 10.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 THIRD PARTY ADMINISTRATOR | Other services; Participant communication; Float revenue; Contract Administrator; Non-monetary compensation; Claims processing; Direct payment from the plan Service code 12 | — | $242K |
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 | 364 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 364 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE | 491 | $29K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 327 | $9K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $50K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE COMPANY | 364 | $497K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 327 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 491 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.