| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $17K | $0 | $17K | 4.97% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST VEVA 16, SUITE 305 BLUE BELL, PA 19422 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $17K | $17K | 4.97% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC DBA RIS | 160 FEDERAL STREET BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $682 | $5K | 11.50% |
| SELMAN & COMPANY, LLC3 | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 5.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $2K | $6K | 14.09% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC DBA RIS | 160 FEDERAL ST BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $506 | $4K | 11.02% |
| SELMAN & COMPANY, LLC3 | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $506 | $506 | 1.42% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC DBA RIS | 160 FEDERAL ST BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $384 | $3K | 11.45% |
| SELMAN & COMPANY, LLC3 | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 5.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC DBA RIS | 160 FEDERAL ST BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $170 | $1K | 11.23% |
| SELMAN & COMPANY, LLC3 | 6110 PARKLAND BLVD CLEVELAND, OH 44124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $572 | $572 | 5.00% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL ST BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $983 | $151 | $1K | 11.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMINISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Float revenue; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $101K |
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 | 248 | 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) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 248 | $341K |
| Other(6 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $171K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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.