| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | PO BOX 5682 CAROL STREAM, IL 60197 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | $68K | $73K | 3.00% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | PO BOX 5682 CAROL STREAM, IL 60197 | VISION SERVICE PLAN | $829 | — | $829 | 2.47% |
| DOMINIUM BENEFITS, LLC3 Filed as: DOMINIUM BENEFITS LLC | 3500 LENOX ROAD ATLANTA, GA 30326 | VISION SERVICE PLAN | $690 | — | $690 | 2.05% |
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 | 204 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 148 | $2.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 148 | $2.4M |
| Vision | VISION SERVICE PLAN | 122 | $34K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 204 | $19K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 204 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.