| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $55K | $55K | 3.13% |
| LOCKTON COMPANIES, LLC3 | PO BOX 3207 BOSTON, MA 02241 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | $0 | $18K | 10.59% |
| PROGRESSIVE BENEFIT SOLUTIONS LLC5 Filed as: PROGRESSIVE BENEFIT SOLUTIONS, LLC | 14 BUSINESS PARK DRIVE, SUITE 8 BRANFORD, CT 06405 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 2.75% |
| LOCKTON COMPANIES, LLC3 | PO BOX 3207 BOSTON, MA 02241 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 9.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 530 PRESTON STREET, 3RD FLOOR MERIDEN, CT 06450 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $47 | $0 | $47 | 0.64% |
| INSURANCE PROFESSIONALS INC3 Filed as: THE INSURANCE PROFESSIONALS INC. | 68 NATIONAL DRIVE GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.23% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HARTFORD LIFE AND ACCIDENT | $165 | $47 | $212 | 19.27% |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 186 | $1.7M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 275 | $1.8M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 200 | $176K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 200 | $169K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 200 | $169K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 186 | $1.7M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 200 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.