| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | AETNA LIFE INSURANCE CO. | $31K | — | $31K | 3.28% |
| MIKE SLADE3 | NAVITECH 8215 ROYAL SAINT GEORGES WAY DULUTH, GA 30097 | LEGALPLANS, USA | $2K | — | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMINISTRATION | Contract Administrator; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $971K |
| DELTA DENTAL OF NJ, INC. EIN 22-1896118 THIRD PARTY ADMINISTRATOR | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $541K |
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 | 2,227 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,659 | $2.1M |
| Dental | ALPHA DENTAL PROGRAMS, INC. | 792 | $137K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 2,627 | $125K |
| Life insurance | AETNA LIFE INSURANCE CO. | 2,227 | $957K |
| Short-term disability | AETNA LIFE INSURANCE CO. | 2,227 | $957K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 2,227 | $957K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,659 | $2.1M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 2,227 | $981K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,659 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.