| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $40K | — | $40K | 4.98% |
| BENEFIT ADVISORS SVS GRP LLC (BASG)3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $7K | $7K | 0.90% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 7231 FOREST AVENUE RICHMOND, VA 23226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 6.29% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 7231 FOREST AVENUE RICHMOND, VA 23226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 6.09% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 7231 FOREST AVENUE RICHMOND, VA 23226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 7.80% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 7231 FOREST AVENUE RICHMOND, VA 23226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $806 | $806 | 7.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 MEDICAL FEES | Other services; Participant communication; Float revenue; Contract Administrator; Named fiduciary; Direct payment from the plan; Non-monetary compensation; Claims processing Service code 12 | — | $198K |
| MED INVESTORS DEVELOPMENT, LLC DBA EIN 46-3155880 OTHER | Other services Service code 49 | ONE TO ONE HEALTH 1110 MARKET STREET, SUITE 502 CHATTANOOGA, TN 37402 | $48K |
| FLORES AND ASSOCIATES EIN 56-1542307 CLAIMS PROCESSING | Claims processing Service code 12 | — | $3K |
| CIGNA | Float revenue; Non-monetary compensation; Contract Administrator; Participant communication; Claims processing; Direct payment from the plan; Other services; Named fiduciary Service code 12 | — | $0 |
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 | 357 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 360 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF VIRGINIA | 589 | $197K |
| Vision(2 contracts) | EYEMED VISION CARE | 519 | $21K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 655 | $63K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 200 | $98K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 354 | $20K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 578 | $813K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 576 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 655 | — |
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."
No prospect flags tripped on this filing.