| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | NEWTOWN ROAD VIRGINIA BEACH, VA 23462 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | $7K | $9K | 0.50% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | AETNA LIFE INSURANCE CO. | $29K | — | $29K | 3.23% |
| MIKE SLADE3 Filed as: MIKE SLADE NAVITECH | 8215 ROYAL SAINT GEORGES WAY DULUTH, GA 30097 | LEGALPLANS, USA | $3K | — | $3K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 THIRD PARTY ADMINISTRATOR | Non-monetary compensation; Float revenue; Claims processing; Other services; Contract Administrator; Direct payment from the plan; Participant communication Service code 12 | — | $817K |
| DELTA DENTAL OF NJ EIN 22-1896118 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | 1639 ROUTE 10 PARSIPPANY, NJ 07054 | $477K |
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 | 1,985 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,985 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,317 | $1.7M |
| Dental | ALPHA DENTAL PROGRAMS INC. | 642 | $120K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 2,344 | $121K |
| Life insurance | AETNA LIFE INSURANCE CO. | 1,985 | $893K |
| Short-term disability | AETNA LIFE INSURANCE CO. | 1,985 | $893K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 1,985 | $893K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,317 | $1.7M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,985 | $921K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,344 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.