| 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 | $77K | $274 | $78K | 9.60% |
| ROGERS BENEFIT GROUP INC3 | 4811 BEACH BLVD #106 JACKSONVILLE, FL 32207 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $31K | $31K | 3.83% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-SEE ATTACHED | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $23K | — | $23K | 3.58% |
| 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 | — | $9K | $9K | 4.96% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | — | $9K | 4.95% |
| SETH JASON KALKSTEIN3 | 29 S. MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 6.08% |
| PAUL GLOBAL BENEFITS INC3 Filed as: E PAUL AMATA | 153 CORNERSTONE DRIVE SOUTH WINDSOR, CA 06074 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 1.31% |
| ROBERT D DAVEY3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 1.27% |
| STEPHEN P WHITTEMORE3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 1.27% |
| SETH JASON KALKSTEIN3 | 29 S. MAIN ST STE 201 WEST HARTFORD, CT 06107 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 7.12% |
| PAUL GLOBAL BENEFITS INC3 Filed as: E PAUL AMATA | 153 CORNERSTONE DR SOUTH WINDSOR, CT 06074 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 1.90% |
| ROBERT D DAVEY3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 1.70% |
| STEPHEN P WHITTEMORE3 Filed as: STEPHEN WHITTEMORE | 27 MOUNTAIN VIEW RD WEATOGUE, CT 06089 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 1.70% |
| SETH JASON KALKSTEIN3 | 29 S. MAIN ST STE 201 WEST HARTFORD, CT 06107 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 6.51% |
| PAUL GLOBAL BENEFITS INC3 Filed as: E PAUL AMATA | 153 CORNER STONE DR SOUTH WINDSOR, CT 06074 | STANDARD INSURANCE COMPANY | $718 | — | $718 | 1.34% |
| ROBERT D DAVEY3 | 29 S MAIN ST SUITE 201 WEST HARTFORD, CT 06107 | STANDARD INSURANCE COMPANY | $710 | — | $710 | 1.32% |
| STEPHEN P WHITTEMORE3 | 27 MOUNTAIN VIEW RD SUITE 201 WEATOGUE, CT 06089 | STANDARD INSURANCE COMPANY | $710 | — | $710 | 1.32% |
| ENROLLEASE3 Filed as: ONE DIGITAL FARMINGTON | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | EYE MED | $1K | — | $1K | 8.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 HLTH/VIS PROVIDER | Direct payment from the plan; Float revenue; Other services; Named fiduciary; Participant communication; Contract Administrator; Claims processing; Non-monetary compensation Service code 12 | — | $161K |
| CIGNA | Other services; Float revenue; Named fiduciary; Claims processing; Contract Administrator; Direct payment from the plan; Non-monetary compensation; Participant communication 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 | 255 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 255 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 252 | $808K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 195 | $175K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 290 | $826K |
| Life insurance | STANDARD INSURANCE COMPANY | 255 | $85K |
| Short-term disability | STANDARD INSURANCE COMPANY | 240 | $54K |
| Long-term disability | STANDARD INSURANCE COMPANY | 240 | $75K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 252 | $808K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 252 | $808K |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 210 | $639K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.