| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | PARK 80 WEST PLAZA TWO 250 PEHLE AVENUE 400 SADDLE BROOK, NJ 07663 | CIGNA HEALTH & LIFE INSURANCE COMPANY & AFFILIATES | $146K | — | $146K | 15.19% |
| LOUIS A DECHIARA3 | 875 3RD AVENUE 23RD FLOOR NEW YORK, NY 10022 | FIRST UNUM LIFE INSURANCE COMPANY | $40K | — | $40K | 6.30% |
| DAVID J HACHEY3 | 245 PARK AVENUE 18TH FLOOR NEW YORK, NY 10167 | FIRST UNUM LIFE INSURANCE COMPANY | $36K | — | $36K | 5.56% |
| PHILIP T DAVIS3 | PO BOX 8865 NEW FAIRFIELD, CT 06812 | FIRST UNUM LIFE INSURANCE COMPANY | $36K | — | $36K | 5.56% |
| CHRISTINA E LAWRENCE3 | 37 EAST 1ST STREET 1W NEW YORK, NY 10003 | FIRST UNUM LIFE INSURANCE COMPANY | $7K | — | $7K | 1.11% |
| CORPORATE CONSULTING SERVICES3 | 605 THIRD AVE 24TH FLOOR NEW YORK, NY 10158 | FIRST UNUM LIFE INSURANCE COMPANY | $10K | — | $10K | 5.78% |
| MARSH & MCLENNAN AGENCY LLC3 | PARK 80 WEST PLAZA TWO 250 PEHLE AVENUE 400 SADDLE BROOK, NJ 07663 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $3K | $458 | $3K | 9.61% |
| CORPORATE CONSULTING SERVICES3 | 605 THIRD AVE 24TH FLOOR NEW YORK, NY 10158 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PARK 80 WEST PLAZA TWO 250 PEHLE AVENUE 400 SADDLE BROOK, NJ 07663 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $904 | $87 | $991 | 16.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA BEHAVIORAL HEALTH INC. EIN 41-1648670 CONTRACTED WITH EMPLOYER | Direct payment from the plan; Contract Administrator; Claims processing; Participant communication Service code 12 | CITIBANK NA ONE PENNS WAY NEW CASTLE, DE 19720 | $7K |
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 | 321 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 321 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH & LIFE INSURANCE COMPANY & AFFILIATES | 565 | $959K |
| Dental | CIGNA HEALTH & LIFE INSURANCE COMPANY & AFFILIATES | 565 | $959K |
| Vision | CIGNA HEALTH & LIFE INSURANCE COMPANY & AFFILIATES | 565 | $959K |
| Life insurance | CIGNA LIFE INSURANCE CO. OF NEW YORK | 0 | $32K |
| Short-term disability(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 321 | $173K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 321 | $165K |
| Prescription drug | CIGNA HEALTH & LIFE INSURANCE COMPANY & AFFILIATES | 565 | $959K |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH & LIFE INSURANCE COMPANY & AFFILIATES | 565 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 565 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.