| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SELMAN & COMPANY, LLC5 Filed as: SELMAN & CO INC | 6110 PARKLAND BLVD CLEVELAND, OH 441244187 | HARTFORD LIFE AND ACCIDENT | $0 | $482 | $482 | 0.06% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | HARTFORD LIFE AND ACCIDENT | $0 | — | $0 | 0.00% |
| CHRISTINE M. MCCULLUGH3 Filed as: CHRISTINE MCCULLUGH | STE 300 16310 NE 80TH ST REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 14.95% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL INC | 75 REMITTANCE DRIVE #1446 CHICAGO, IL 60675 | HARTFORD LIFE AND ACCIDENT | — | $212 | $212 | 0.27% |
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 | 774 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 555 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,329 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,895 | $608K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,895 | $608K |
| Vision(3 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,237 | $123K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,879 | $845K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,879 | $845K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,879 | $845K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,895 | $608K |
| Other(4 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,879 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,895 | — |
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.