| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KENNETH NICHOLS3 | 116 SANTIAGO DRIVE JUPITER, FL 33458 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | — | $13K | 7.47% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. FIN. DBA BENEFIT M | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $9K | $9K | 4.95% |
| KENNETH NICHOLS3 | 116 SANTIAGO DRIVE JUPITER, FL 33458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 11.14% |
| BENEFITMALL3 | 354 EISENHOWER PKWY STE 2850 LIVINGSTON, NJ 07039 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $563 | $3K | 5.00% |
| BENEFITMALL3 | 250 WOLD WILSON BRIDGE RD STE 190 WORTHINGTON, OH 43085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 4.60% |
| KENNETH NICHOLS3 | 116 SANTIAGO DRIVE JUPITER, FL 33458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 6.62% |
| BENEFITMALL3 | 250 WOLD WILSON BRIDGE RD STE 190 WORTHINGTON, OH 43085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 5.06% |
| BENEFITMALL3 | 354 EISENHOWER PKWY STE 2850 LIVINGSTON, NJ 07039 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $510 | $3K | 5.00% |
| KENNETH NICHOLS3 | 116 SANTIAGO DRIVE JUPITER, FL 33458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 13.00% |
| BENEFITMALL3 | 250 WOLD WILSON BRIDGE RD STE 190 WORTHINGTON, OH 43085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 5.07% |
| BENEFITMALL3 | 354 EISENHOWER PKWY LIVINGSTON, NJ 07039 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $383 | $2K | 5.00% |
| KENNETH NICHOLS3 | 116 SANTIAGO DRIVE JUPITER, FL 33458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $347 | — | $347 | 12.02% |
| BENEFITMALL3 | 250 WOLD WILSON BRIDGE RD STE 190 WORTHINGTON, OH 43085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $151 | $151 | 5.23% |
| BENEFITMALL3 | 354 EISENHOWER PKWY STE 2850 LIVINGSTON, NJ 07039 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $116 | $28 | $144 | 4.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KENNETH C NICHOLS BROKER | Insurance brokerage commissions and fees Service code 53 | 116 SANTIAGO DRIVE JUPITER, FL 33458 | $169K |
| CENTERSTONE INS & FIN SVC LLC GENERAL AGENT | Insurance brokerage commissions and fees Service code 53 | 354 EISENHOWER PKWY STE 2850 LIVINGSTON, NJ 07039 | $67K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMINISTRATOR | Participant communication; Float revenue; Other services; Non-monetary compensation; Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary Service code 12 | — | $55K |
| CIGNA | Non-monetary compensation; Float revenue; Participant communication; Named fiduciary; Contract Administrator; Direct payment from the plan; Claims processing; Other services 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 | 269 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 221 | $179K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 221 | $179K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 269 | $60K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 269 | $52K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $41K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 269 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 269 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.