| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES, MURPHY & ASSOCIATES, INC. | ATTN OPERATIANG ACCOUNT P.O. BOX 441 DES MOINES, IA 50302 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 0.99% |
| HOLMES MURPHY & ASSOCIATES3 | ATTN OPERATING ACCOUNT P.O. BOX 441 DES MOINES, IA 50302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $64K | $19K | $82K | 12.92% |
| AVANT SPECIALTY BENEFITS LLC3 Filed as: AVANT SPECIALTY BENEFITS | 1828 WALNUT STREET SUITE 700 KANSAS CITY, MO 64108 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 2.00% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES, MURPHY & ASSOCIATES | ATTN OPERATING ACCOUNT P.O. BOX 441 DES MOINES, IA 59302 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 10.00% |
| AVANT SPECIALTY BENEFITS LLC3 Filed as: AVANT SPECIALTY BENEFITS | 1328 WALNUT STREET SUITE 700 KANSAS CITY, MO 64108 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $319 | — | $319 | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $1.4M |
| HOLMES MURPHY AND ASSOCIATES EIN 42-0985055 BROKER | Other commissions Service code 55 | — | $70K |
| RXBENEFITS EIN 63-1157085 CLAIMS PROCESSING | Claims processing Service code 12 | — | $33K |
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 | 1,892 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,903 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,874 | $1.2M |
| Vision | EYEMED VISION CARE ON BEHALF OF THE COMBINED INSURANCE CO. OF AMERICA | 2,806 | $172K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,891 | $638K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,892 | $654K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,891 | $638K |
| Stop-loss / reinsurancereinsurance | HM INSURANCE GROUP | 1,856 | $1.4M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,891 | $678K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,279 | — |
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.