| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN INC | 2307 E AURORA B13 TWINSBURG, OH 440871952 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $68K | — | $68K | 10.53% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN INC | 2307 E AURORA B13 TWINSBURG, OH 44087 | AETNA LIFE INSURANCE COMPANY | $11K | — | $11K | 6.49% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN INC | 2307 E AURORA B13 TWINSBURG, OH 440871952 | HARTFORD LIFE AND ACCIDENT | $12K | — | $12K | 13.88% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN INC | 2307 E AURORA B13 TWINSBURG, OH 440871952 | NATIONAL GUARDIAN LIFE | $1K | — | $1K | 4.58% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN INC | 2307 E AURORA B13 TWINSBURG, OH 44087 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Participant communication; Non-monetary compensation; Other services; Claims processing; Direct payment from the plan; Contract Administrator; Named fiduciary; Float revenue Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $75K |
| AMERICAN BENEFITS EIN 04-3216327 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 320 RIVERSIDE DRIVE, P.O. BOX 1209 NORTHHAMPTON, MA 010611209 | $9K |
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 | 251 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 251 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 350 | $644K |
| Dental | AETNA LIFE INSURANCE COMPANY | 531 | $175K |
| Vision | NATIONAL GUARDIAN LIFE | 210 | $25K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 251 | $84K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 251 | $84K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 350 | $644K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 350 | $644K |
| Other(2 contracts) | HARTFORD LIFE AND ACCIDENT | 251 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 531 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.