| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIA INSURANCE SERVICES INC3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $3K | — | $3K | 0.39% |
| FIA INSURANCE SERVICES INC3 | — | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $2K | — | $2K | 3.04% |
| FIA INSURANCE SERVICES IN3 | 9 SOUTH LAKE AVENUE STE 300 PASADENA, CA 91101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $984 | $3K | 8.22% |
| FIA INSURANCE SERVICES IN3 | 99 SOUTH LAKE AVENUE STE 300 PASADENA, CA 91101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $825 | $5K | 13.36% |
| FIA INSURANCE SERVICES IN3 | 99 SOUTH LAKE AVENUE STE 300 PASADENA, CA 91101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $353 | $3K | 17.23% |
| FIA INSURANCE SERVICES INC3 | — | CIGNA DENTAL HEALTH OF NEW JERSEY, INC. | $285 | — | $285 | 3.14% |
| FIA INSURANCE SERVICES IN3 | 99 SOUTH LAKE AVENUE STE 300 PASADENA, CA 91101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $858 | $132 | $990 | 15.00% |
| FIA INSURANCE SERVICES IN3 | 99 SOUTH LAKE AVENUE STE 300 PASADENA, CA 91101 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $854 | $134 | $988 | 15.04% |
| FIA INSURANCE SERVICES IN3 | 99 SOUTH LAKE AVENUE STE 300 PASADENA, CA 91101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $140 | $123 | $263 | 5.54% |
| FIA INSURANCE SERVICES INC3 | — | CIGNA DENTAL HEALTH OF ILLINOIS, INC. | $165 | — | $165 | 3.64% |
| FIA INSURANCE SERVICES INC3 | — | CIGNA DENTAL HEALTH OF FLORIDA, INC. | $80 | — | $80 | 2.94% |
| FIA INSURANCE SERVICES INC3 | — | CIGNA DENTAL HEALTH OF TEXAS, INC. | $52 | — | $52 | 2.87% |
| FIA INSURANCE SERVICES IN3 | 99 SOUTH LAKE AVENUE STE 300 PASADENA, CA 91101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $473 | $44 | $517 | 34.72% |
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 | 320 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 324 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTHCARE OF CALIFORNIA | 231 | $1.1M |
| Dental(7 contracts, 7 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 526 | $880K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 290 | $55K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 290 | $35K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 526 | $1.3M |
| Other(5 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 526 | $738K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 526 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.