| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $229K | $10K | $238K | 3.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | COMMUNITY INSURANCE COMPANY | $74K | $2K | $76K | 1.89% |
| SHAWAN MARQUIS AGENCY INC3 Filed as: SHAWAN MARQUIS AGENCY, INC. | 425 METRO PLACE NORTH, SUITE 140 DUBLIN, OH 43017 | COMMUNITY INSURANCE COMPANY | $56 | $0 | $56 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | ONE JERICHO PLAZA, SUITE 200 JERICHO, NY 11753 | EMBLEMHEALTH | $56K | $0 | $56K | 3.85% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW JERSEY | 56 LIVINGSTON AVENUE PO BOX 369 ROSELAND, NJ 07068 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $14K | $0 | $14K | 4.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $4K | $0 | $4K | 1.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | ONE JERICHO PLAZA, SUITE 200 JERICHO, NY 11753 | HM LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.00% |
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 | 1,015 | 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) | 1,015 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 832 | $11.8M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 832 | $10.3M |
| Vision(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 733 | $4.1M |
| Life insurance | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,015 | $317K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,015 | $317K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 832 | $11.8M |
| Other | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,015 | $317K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,015 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.