| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 350 HUDSON STREET 4TH FL NEW YORK, NY 10014 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $52K | $52K | 2.68% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1 CALIFORNIA ST STE 100 SAN FRANCISCO, CA 94111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $23K | $23K | 1.21% |
| FRENKEL BENEFITS LLC3 | 350 HUDSON ST 4TH FL NEW YORK, NY 10014 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | $1K | — | $1K | 1.23% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD #800 CONCORD, CA 94520 | EYEMED | $2K | — | $2K | 7.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CONTRACT ADMINISTRATOR | Plan Administrator; Contract Administrator Service code 13 | — | $82K |
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 | 198 | 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) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 214 | $1.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 180 | $148K |
| Vision | EYEMED | 293 | $23K |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 221 | $0 |
| Short-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 196 | $0 |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 196 | $0 |
| Other(2 contracts) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 221 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.