| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $75K | $75K | 2.27% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PR 19428 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $71K | $71K | 2.16% |
| ROGERS BENEFIT GROUP INC3 | 5110 N. 40TH ST. STE 234 PHOENIX, AZ 85018 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $66K | $66K | 2.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 200 SUMMIT LAKE DRIVE SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $52K | $7K | $60K | 7.90% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 8144 WALNUT HILL LANE 16TH FLOOR DALLAS, TX 75231 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $31K | $8K | $40K | 5.24% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 234662949 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | — | $6K | 2.59% |
| MARSH & MCLENNAN AGENCY LLC3 | 8144 WALNUT HILL LANE 16TH FLOOR DALLAS, TX 75231 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | — | $5K | 2.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $135K |
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 | 332 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 343 | 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 | 425 | $3.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $755K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $755K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $755K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $755K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $755K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $755K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 425 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.