| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SAFEGUARD GROUP INC3 | 100 GRANITE DRIVE SUITE 109 MEDIA, PA 19063 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 0.20% |
| STRATEBEN INC3 Filed as: STRATEBEN INC. | 4720 MONTGOMERY LANE SUITE 500 BETHESDA, MD 20814 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 0.20% |
| STRATEBEN INC3 Filed as: STRATEBEN, INC | 4720 MONTGOMERY LANE SUITE 500 BETHESDA, MD 20814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $0 | $14K | 10.93% |
| SAFEGUARD GROUP INC3 Filed as: THE SAFEGUARD GROUP INC | 100 GRANITE DRIVE SUITE 205 MEDIA, PA 19063 | VISION BENEFITS OF AMERICA | $387 | $0 | $387 | 3.00% |
| STRATEBEN INC3 | 4720 MONTGOMERY LANE SUITE 500 BETHESDA, MD 20814 | VISION BENEFITS OF AMERICA | $258 | $0 | $258 | 2.00% |
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 | 194 | 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) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 237 | $1.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 237 | $1.6M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 237 | $1.6M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $125K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $125K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $125K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 237 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.