| 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 | $184K | $9K | $193K | 3.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | COMMUNITY INSURANCE COMPANY | $62K | $8K | $70K | 1.43% |
| SHAWAN MARQUIS AGENCY INC3 Filed as: SHAWAN MARQUIS AGENCY, INC. | 110 EAST WILSON BRIDGE ROAD SUITE 260 COLUMBUS, OH 43085 | COMMUNITY INSURANCE COMPANY | $34 | $0 | $34 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | ONE JERICHO PLAZA, SUITE 200 JERICHO, NY 11753 | EMBLEMHEALTH | $59K | $0 | $59K | 3.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $21K | $9K | $30K | 6.84% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW JERSEY, INC. | 56 LIVINGSTON AVENUE PO BOX 369 ROSELAND, NJ 07068 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $0 | $2K | $2K | 0.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | ONE JERICHO PLAZA, SUITE 200 JERICHO, NY 11753 | HM LIFE INSURANCE COMPANY | $8K | $0 | $8K | 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 | 1,116 | 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) | 1,116 | 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 | 1,658 | $12.6M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,658 | $11.1M |
| Vision(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 1,658 | $5.0M |
| Life insurance | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,096 | $440K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,096 | $440K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,658 | $12.6M |
| Other | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,096 | $440K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,658 | — |
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.