| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | $62K | $66K | 3.08% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC DBA RIS | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $567 | $10K | 27.64% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & COMPANY | 6110 PARKLAND BLVD C, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS | 669 RIVER DR CENTER II ELMWOOD PARK, NJ 07407 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $211 | $211 | 0.60% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS BROKERS (SEE ATTACHED) | — | COMBINED INSURANCE COMPANY | $24K | $0 | $24K | 85.07% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS BROKERS SEE ATTACHED | — | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $7K | $0 | $7K | 25.77% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $310 | $8K | 43.86% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & COMPANY | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $956 | $956 | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS | 669 RIVER DR CENTER II ELMWOOD PARK, NJ 07407 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $116 | $116 | 0.61% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS BROKERS (SEE ATTACHED) | — | COMMUNITY INSURANCE COMPANY | $4K | $0 | $4K | 27.12% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $131 | $3K | 37.73% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & COMPANY | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $408 | $408 | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS | 669 RIVER DR CENTER II ELMWOOD PARK, NJ 07407 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $49 | $49 | 0.60% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC DBA RIS | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $737 | $26 | $763 | 46.78% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & COMPANY | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $82 | $82 | 5.03% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS | 669 RIVER DR CENTER II E, NJ 07407 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $8 | $8 | 0.49% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS BROKERS - (SEE ATTACHED) | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $73 | $0 | $73 | 8.68% |
No Schedule C service providers reported on this filing.
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 90 | $2.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 90 | $2.2M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 90 | $2.2M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $8K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $35K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $19K |
| Other(5 contracts, 5 carriers) | COMBINED INSURANCE COMPANY | 139 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.