| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST | 445 ROSS AVE DALLAS, TX 75202 | COMPANION LIFE INSURANCE COMPANY | $134K | — | $134K | 9.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST | 1901 GATEWAY DR SUITE 200 IRVING, TX 75038 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $26K | — | $26K | 6.66% |
| SUMMIT GROUP OF VIRGINIA3 Filed as: SUMMIT GLOBAL PARTNERS OF TEXAS INC | 1445 ROSS AVE SUITE 4200 DALLAS, TX 75202 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 1.43% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST | 2711 N HASKELL AVE SUITE 2000 DALLAS, TX 75204 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $17K | — | $17K | 8.09% |
| SUMMIT GROUP OF VIRGINIA3 Filed as: SUMMIT GLOBAL PARTNERS OF TEXAS INC | 1445 ROSS AVE SUITE 4200 DALLAS, TX 75202 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $3K | — | $3K | 1.66% |
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFITS PROGRAMS INC | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $49K | — | $49K | 50.01% |
| CUSTOM BENEFITS PROGRAMS3 | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 2.08% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST | 2711 N HASKELL AVE SUITE 2000 DALLAS, TX 75204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.08% |
| SUMMIT GROUP OF VIRGINIA3 Filed as: SUMMIT GLOBAL PARTNERS OF TEXAS INC | 2711 N HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $778 | $9K | 16.47% |
| SUMMIT GROUP OF VIRGINIA3 Filed as: SUMMIT GLOBAL PARTNERS OF TEXAS INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 9.95% |
| SUMMIT GROUP OF VIRGINIA3 Filed as: SUMMIT GLOBAL PARTNERS OF TEXAS INC | 2711 N HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $610 | $7K | 16.49% |
| SUMMIT GROUP OF VIRGINIA3 Filed as: SUMMIT GLOBAL PARTNERS OF TEXAS INC | 2711 N HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $378 | $3K | 16.88% |
| SUMMIT GROUP OF VIRGINIA3 Filed as: SUMMIT GLOBAL PARTNERS OF TEXAS INC | 2711 N HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $107 | $2K | 16.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 PLAN ADMINISTRATOR | Contract Administrator; Claims processing; Non-monetary compensation; Participant communication; Other services; Named fiduciary; Direct payment from the plan; Float revenue Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $15K |
| CIGNA HEALTH AND LIFE INSURANCE CO | Non-monetary compensation; Claims processing; Contract Administrator; Named fiduciary; Float revenue; Participant communication; Other services; Direct payment from the plan Service code 12 | — | $0 |
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 | 831 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 831 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 97 | $386K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 596 | $210K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 831 | $49K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 349 | $41K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 181 | $53K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $20K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 429 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 831 | — |
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.