| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 7 GIRALDA FARMS, 2ND FLOOR MADISON, NJ 07940 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $220K | $3K | $223K | 1.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203066 DALLAS, TX 75320 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $27K | — | $27K | 0.12% |
| MEIJI YASUDA AMERICA, INC.3 | 780 3RD AVENUE, 42ND FLOOR NEW YORK, NY 10017 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $123 | — | $123 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203066 DALLAS, TX 75320 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $17K | — | $17K | 1.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 823237 PHILADELPHIA, PA 19182 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $8K | $2K | $10K | 1.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 7 GIRALDA FARMS, 2ND FLOOR MADISON, NJ 07940 | CIGNA HEALTHCARE OF CALIFORNIA | $7K | — | $7K | 1.02% |
| MEIJI YASUDA AMERICA, INC.3 | 780 3RD AVENUE, 42ND FLOOR NEW YORK, NY 10017 | CIGNA HEALTHCARE OF CALIFORNIA | $4 | — | $4 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 823237 PHILADELPHIA, PA 19182 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $939 | — | $939 | 0.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203066 DALLAS, TX 75320 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $264 | — | $264 | 0.28% |
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 | 1,609 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 174 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,783 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 3,780 | $22.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 3,780 | $21.5M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 3,780 | $21.5M |
| Life insurance(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 3,780 | $22.5M |
| Short-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,609 | $94K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,609 | $992K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 3,780 | $22.2M |
| Other | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,609 | $992K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,780 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.