| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BLVD 2ND FLOOR HAUPPAUGE, NY 11788 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $63K | $63K | 1.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF NEW YORK EIN 11-1980218 DENTAL ADMIN | Claims processing; Contract Administrator Service code 12 | — | $17K |
| WAGEWORKS, INC. COBRA/FSA ADMIN | Contract Administrator; Claims processing Service code 12 | 4609 REGENT BLVD IRVING, TX 75063 | $8K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 EAP ADMIN | Direct payment from the plan; Participant communication; Claims processing; Contract Administrator Service code 12 | — | $8K |
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 | 236 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 54 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 122 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 412 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 236 | $4.2M |
| Vision | EYEMED VISION CARE | 416 | $37K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 341 | $72K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 110 | $39K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 89 | $32K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 341 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 416 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.