| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC0 Filed as: ACRISURE | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MN 49316 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $28K | — | $28K | 5.54% |
| CIGNA3 Filed as: CIGNA HEALTH AND LIFE INSURNACE COM | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $25K | $25K | 5.06% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SERV (NY) | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $11K | — | $11K | 2.12% |
| MICHAEL P WATERS3 | 1325 FRANKLIN AVE SUITE 540 GARDEN CITY, NJ 11530 | ANTHEM HEALTH PLANS OF VIRGINIA, INC | $12K | $0 | $12K | 2.52% |
| ACRISURE LLC3 Filed as: ACCRISURE LLC DBA CLG | 5664 PRAIRIE CREEK DR CALEDONIA, MN 49316 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $6K | — | $6K | 11.26% |
| EMERSON REID LLC3 | 1305 WALT WHITMAN RD SUITE 310 MELVILLE, NY 11747 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $3K | — | $3K | 5.00% |
| ACRISURE LLC3 Filed as: ACCRISURE, LLC | 555 TAXTER RD SUITE 125 ELMSFORD, NY 10523 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 7.82% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SERV (NY) | 1133 WESTCHESTER AVE SUITE 229 WHITE PLAINS, NY 10604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.75% |
| TSG FINANCIAL LLC3 | — | ANTHEM HEALTH PLANS OF VIRGINIA, INC | $1K | — | $1K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 INSURANCE AGENCY | Named fiduciary; Float revenue; Other services; Direct payment from the plan; Contract Administrator; Participant communication; Non-monetary compensation; Claims processing Service code 12 | 900 COTTAGE GROVE RD BLOOMSFIELD, CT 06002 | $10K |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 141 | 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 | 141 | $975K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $75K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $46K |
| Short-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 142 | $55K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 142 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.