| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LP INSURANCE SERVICE INC.3 | 300 E. 2ND STREET SUITE 1300 JUPITER, FL 33458 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $33K | — | $33K | 11.71% |
| LP INSURANCE SERVICE INC.3 | 300 E. 2ND STREET SUITE 1300 RENO, NV 89501 | UNITED HEALTH CARE INSURANCE COMPANY | $8K | — | $8K | 14.66% |
| TIM HOLLAND3 | 300 E. 2ND STREET SUITE 1300 JUPITER, FL 33458 | RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 10.00% |
| LP INSURANCE SERVICE INC.3 | 300 E. 2ND STREET SUITE 1300 RENO, NV 89501 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $155 | — | $155 | 13.04% |
| TIM HOLLAND3 | 300 E. 2ND STREET SUITE 1300 RENO, NV 89501 | RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | $5K | — | $5K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 NONE | Participant communication; Named fiduciary; Non-monetary compensation; Float revenue; Insurance agents and brokers; Other services; Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $25K |
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 | 156 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 188 | $284K |
| Dental(2 contracts) | RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | 72 | $50K |
| Vision(2 contracts) | RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | 81 | $20K |
| Life insurance | UNITED HEALTH CARE INSURANCE COMPANY | 260 | $55K |
| Short-term disability | UNITED HEALTH CARE INSURANCE COMPANY | 260 | $55K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 7 | $1K |
| Other | UNITED HEALTH CARE INSURANCE COMPANY | 260 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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.