| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $65K | — | $65K | 8.75% |
| ROGERS BENEFIT GROUP INC3 | 4811 BEACH BLVD #106 JACKSONVILLE, FL 32207 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $26K | $26K | 3.50% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $8K | — | $8K | 4.96% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEIT GROUP INC. | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $6K | $6K | 3.96% |
| SETH JASON KALKSTEIN3 | 60 AVON MEADOW LN AVON, CT 06001 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.41% |
| PAUL GLOBAL BENEFITS INC3 Filed as: E PAUL AMATA | 153 CORNERSTONE DR SOUTH WINDSOR, CT 06074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.41% |
| ROBERT D DAVEY3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $714 | — | $714 | 2.27% |
| STEPHEN P WHITTEMORE3 Filed as: STEPHEN WHITTEMORE | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $714 | — | $714 | 2.27% |
| SETH JASON KALKSTEIN3 | 60 AVON MEADOW LN AVON, CT 06001 | UNITED OF OMAHA LIFE INSURANCE CO | $679 | — | $679 | 3.00% |
| PAUL GLOBAL BENEFITS INC3 Filed as: E PAUL AMATA | 153 CORNER STONE DR SOUTH WINDSOR, CT 06074 | UNITED OF OMAHA LIFE INSURANCE CO | $679 | — | $679 | 3.00% |
| ROBERT D DAVEY3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | UNITED OF OMAHA LIFE INSURANCE CO | $453 | — | $453 | 2.00% |
| STEPHEN P WHITTEMORE3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | UNITED OF OMAHA LIFE INSURANCE CO | $453 | — | $453 | 2.00% |
| SETH JASON KALKSTEIN3 | 60 AVON MEADOW LN AVON, CT 06001 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $780 | — | $780 | 4.50% |
| PAUL GLOBAL BENEFITS INC3 Filed as: E PAUL AMATA | 153 CORNERSTONE DR SOUTH WINDSOR, CT 06074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $780 | — | $780 | 4.50% |
| ROBERT D DAVEY3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $520 | — | $520 | 3.00% |
| STEPHEN P SHITTEMORE3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $520 | — | $520 | 3.00% |
| SETH JASON KALKSTEIN3 | 60 AVON MEADOW LN AVON, CT 06001 | UNITED OF OMAHA LIFE INSURANCE CO | $506 | — | $506 | 3.00% |
| PAUL GLOBAL BENEFITS INC3 Filed as: E PAUL AMATA | 153 CORNERSTONE DRIVE SOUTH WINDSOR, CA 06074 | UNITED OF OMAHA LIFE INSURANCE CO | $506 | — | $506 | 3.00% |
| ROBERT D DAVEY3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | UNITED OF OMAHA LIFE INSURANCE CO | $338 | — | $338 | 2.00% |
| STEPHEN P WHITTEMORE3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | UNITED OF OMAHA LIFE INSURANCE CO | $338 | — | $338 | 2.00% |
| ENROLLEASE3 Filed as: ONE DIGITAL FARMINGTON | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | EYE MED | $2K | — | $2K | 11.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 HLTH/VIS PROVIDER | Contract Administrator; Direct payment from the plan; Participant communication; Other commissions; Non-monetary compensation; Claims processing; Insurance brokerage commissions and fees; Named fiduciary; Other services; Float revenue Service code 12 | — | $182K |
| CIGNA | Contract Administrator; Named fiduciary; Other services; Claims processing; Float revenue; Participant communication; Non-monetary compensation; Direct payment from the plan 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 | 199 | 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) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 235 | $744K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 186 | $156K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 285 | $757K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 209 | $34K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 199 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 199 | $31K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 235 | $744K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 235 | $744K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 78 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 285 | — |
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.