| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUGGIERI, PHILIP3 | 355 LEXINGTON AVE 22ND FL NEW YORK, NY 10017 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $72K | $0 | $72K | 4.10% |
| RUGGIERI, PHILIP3 | 355 LEXINGTON AVE 22ND FL NEW YORK, NY 10017 | CIGNA HEALTHCARE OF CALIFORNIA | $6K | $0 | $6K | 3.55% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $2K | $0 | $2K | 2.72% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $1K | $0 | $1K | 3.54% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $680 | $0 | $680 | 12.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1393 VETERANS MEMORIAL HWY SUITE 210N HAUPPAUGE, NY 11788 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $91 | $0 | $91 | 14.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 NONE | Participant communication; Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $2K |
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 | 279 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 283 | 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 | 326 | $1.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 326 | $1.8M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 326 | $1.8M |
| Life insurance | CIGNA LIFE INSURANCE CO. OF NEW YORK | 272 | $32K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 262 | $65K |
| Other(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 272 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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.