| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $749 | $0 | $749 | 0.49% |
| CLEARPATH BENEFIT ADVISORS LLC3 | 300 SPRUCE STREET SUITE 250 COLUMBUS, OH 43215 | COMMUNITY INSURANCE COMPANY | $1K | $271 | $2K | 8.24% |
| CLEARPATH BENEFIT ADVISORS LLC3 | 300 SPRUCE STREET SUITE 250 COLUMBUS, OH 43215 | AMERICAN UNITED LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.89% |
| CLEARPATH BENEFIT ADVISORS LLC3 | 300 SPRUCE STREET SUITE 250 COLUMBUS, OH 43215 | VISION SERVICE PLAN | $500 | $0 | $500 | 10.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MESIROW INSURANCE SERVICES INC 3 | Consulting fees Service code 70 | — | $21K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 3 | Claims processing Service code 12 | — | $14K |
| CIGNA | Contract Administrator; Named fiduciary; Direct payment from the plan; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | — | $0 |
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 | 76 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 76 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 47 | $153K |
| Dental | COMMUNITY INSURANCE COMPANY | 49 | $21K |
| Vision | VISION SERVICE PLAN | 40 | $5K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 76 | $20K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 76 | $20K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 76 | $20K |
| Other | AMERICAN UNITED LIFE INSURANCE COMPANY | 76 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 76 | — |
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.