| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HR BENEFITS SERVICES, INC.3 Filed as: DS BENEFITS GROUP LLC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA DBA CIGNA GROUP INSURANCE | — | -$13K | -$13K | -1.48% |
| HR BENEFITS SERVICES, INC.3 Filed as: DS BENEFITS GROUP, LLC | 3555 RESERVE COMMONS DR. MEDINA, OH 44256 | LIFE INSURANCE COMPANY OF NORTH AMERICA DBA CIGNA GROUP INSURANCE | $133K | -$12K | $121K | 13.64% |
| HR BENEFITS SERVICES, INC.3 Filed as: DS BENEFITS GROUP LLC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA DBA CIGNA GROUP INSURANCE | — | -$10K | -$10K | -1.50% |
| HR BENEFITS SERVICES, INC.3 Filed as: DS BENEFITS GROUP LLC | — | VISION SERVICE PLAN | $0 | — | $0 | 0.00% |
| HR BENEFITS SERVICES, INC.3 Filed as: DS BENEFITS GROUP LLC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA DBA CIGNA GROUP INSURANCE | — | -$2K | -$2K | -1.57% |
| HR BENEFITS SERVICES, INC.3 Filed as: DS BENEFITS GROUP LLC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA DBA CIGNA GROUP INSURANCE | — | -$974 | -$974 | -1.34% |
| HR BENEFITS SERVICES, INC.3 Filed as: DS BENEFITS GROUP LLC | — | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 9.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL, IN | 3475 PIEDMONT RD. SUITE 800 ATLANTA, GA 30305 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH | $0 | — | $0 | 0.00% |
No Schedule C service providers reported on this filing.
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 | 4,762 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 247 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,009 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA DBA CIGNA GROUP INSURANCE | 899 | $653K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 3,728 | $2.3M |
| Vision | VISION SERVICE PLAN | 2,769 | $531K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA DBA CIGNA GROUP INSURANCE | 4,663 | $911K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA DBA CIGNA GROUP INSURANCE | 4,657 | $634K |
| Other(7 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA DBA CIGNA GROUP INSURANCE | 4,663 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,663 | — |
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.