| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 8299 PASADENA, CA 911098299 | VISION CARE | $874 | — | $874 | 9.64% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | METLIFE LEGAL PLANS | $134 | $28 | $162 | 3.43% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | AIS DB EB OP ACCOUNT PO BOX 745977 LOS ANGELES, CA 90074 | METLIFE LEGAL PLANS | $96 | — | $96 | 2.03% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 3600 N CAPITAL OF TEXAS HWY SUITE B-200 AUSTIN, TX 78746 | METLIFE LEGAL PLANS | — | $61 | $61 | 1.29% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | METLIFE LEGAL PLANS | — | $53 | $53 | 1.12% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | DB-EB OPERATING ACCOUNT PO BOX 8299 PASADENA, CA 91109 | METLIFE LEGAL PLANS | — | $21 | $21 | 0.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 MEDICAL FEES | Float revenue; Named fiduciary; Claims processing; Contract Administrator; Direct payment from the plan; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $3K |
| CIGNA | Participant communication; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services; Claims processing; Contract Administrator 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 | 88 | 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) | 88 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 173 | $985K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 173 | $994K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 173 | $985K |
| Other | METLIFE LEGAL PLANS | 10 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.