| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203066 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $1K | $6K | 6.34% |
| COMPLIANCE SERVICES AGENCY3 | 9 HOMEWOOD COURT MAYS LANDING, NJ 08330 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 2.32% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE, SUITE 100 KING OF PRUSSIA, PA 19406 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 8.91% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203066 DALLAS, TX 75320 | AMERICAN HERITAGE LIFE | $1K | — | $1K | 6.25% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE, SUITE 100 KING OF PRUSSIA, PA 19406 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $225 | — | $225 | 10.00% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE, SUITE 100 KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $202 | — | $202 | 9.18% |
No Schedule C service providers reported on this filing.
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 56 | $67K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2 | $43K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 149 | $97K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 149 | $94K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 149 | $94K |
| Prescription drug | AMERICAN HERITAGE LIFE | 56 | $22K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 149 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 149 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.