| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY SUITE 300 RICHFIELD, OH 44286 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $65K | — | $65K | 9.09% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY STE 300 RICHFIELD, OH 44286 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $17 | $14K | 5.69% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO, LLC | 3900 KINROSS LAKES PKWY SUITE 300 RICHFIELD, OH 44286 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 13.76% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION | 199 SCOTT ST SUITE 800 BUFFALO, NY 14204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8 | $64 | $72 | 0.35% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY STE 300 RICHFIELD, OH 44286 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $17 | $3K | 14.10% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST FL 8 BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | — | $89 | $89 | 0.45% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY #300 RICHFIELD, OH 44286 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.18% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION | 199 SCOTT ST SUITE 800 BUFFALO, NY 14204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $57 | $57 | 0.36% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY #300 RICHFIELD, OH 44286 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION | 199 SCOTT ST SUITE 800 BUFFALO, NY 14204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $41 | $41 | 0.31% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY #300 RICHFIELD, OH 44286 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $732 | — | $732 | 12.00% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION | 199 SCOTT ST SUITE 800 BUFFALO, NY 14204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $8 | $8 | 0.13% |
| ASSUREDPARTNERS4 Filed as: ASSURED PARTNERS OF COLORADO | 4582 S ULSTER ST STE 600 DENVER, CO 80237 | PRE-PAID LEGAL SERVICES INC. | $867 | — | $867 | 22.02% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY STE 300 RICHFIELD, OH 44286 | METROPOLITAN LIFE INSURANCE COMPANY | $149 | $17 | $166 | — |
| LIAZON BENEFITS INC3 | 199 SCOTT ST FL 8 BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | — | $50 | $50 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 PLAN ADMINISTRATION | Contract Administrator; Claims processing Service code 12 | — | $157K |
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 | 244 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 172 | $734K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 468 | $243K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 468 | $243K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 468 | $243K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 49 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 71 | $20K |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 468 | $269K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 468 | — |
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.