| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FLEISCHER JACOBS & ASSOCIATES INC3 Filed as: FLEISCHER JACOBS & ASSOCIATES INC. | 620 HINESBURG ROAD, SUITE 220 SOUTH BURLINGTON, VT 05403 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $34K | — | $34K | 8.97% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICE NY LLC | 340 MADISON AVENUE, 21ST FL NEW YORK, NY 10010 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $1K | $1K | 0.34% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 225 NE MIZNER BLVD, STE 675 BOCA RATON, FL 33432 | STANDARD INSURANCE COMPANY | $4K | $905 | $5K | 11.73% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 225 NE MIZNER BLVD, STE 675 BOCA RATON, FL 33432 | STANDARD INSURANCE COMPANY | $2K | $514 | $2K | 10.20% |
| BENANTONIO S. FORGIONE3 | PO BOX 1320 CONCORD, NH 03302 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 40.85% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 225 NE MIZNER BLVD, STE 675 BOCA RATON, FL 33432 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 27.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 PROVIDER | Contract Administrator Service code 13 | — | $7K |
| CIGNA | Non-monetary compensation; Contract Administrator; Float revenue; Claims processing; Named fiduciary; Direct payment from the plan; Participant communication; Other services 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 | 106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 131 | $380K |
| Life insurance | STANDARD INSURANCE COMPANY | 108 | $23K |
| Long-term disability | STANDARD INSURANCE COMPANY | 110 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.