| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | PO BOX 350 CONSHOHOCKEN, PA 19428 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $39K | $39K | 4.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | PO BOX 350 CONSHOHOCKEN, PA 19428 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $944 | $944 | 1.31% |
| PAYCOM PAYROLL LLC5 Filed as: PAYCOM PAYROLL | 7501 WEST MEMORIAL ROAD OKALHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $10K | $10K | 14.19% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 7202 EAST ROSEWOOD STREET SUITE 200 TUCSON, AZ 85710 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 11.09% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 7202 EAST ROSEWOOD STREET SUITE 200 TUCSON, AZ 85751 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 8.52% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF ARIZONA, INC. | 2800 NORTH CENTRAL AVENUE PHOENIX, AZ 85004 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 6.61% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | 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 | 124 | $1.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 102 | $72K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 102 | $72K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 218 | $70K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 218 | $70K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $983K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 218 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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.