| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE ONE BENEFITS3 | 220 PERRY STREET SUITE 200 FOSTORIA, OH 44830 | CIGNA | $33K | — | $33K | 6.51% |
| CORPORATE ONE BENEFITS3 | 220 PERRY STREET SUITE 200 FOSTORIA, OH 44830 | GUARDIAN | $15K | — | $15K | 11.57% |
| LUCIDO MORRIS ASSOCIATES, LLC3 Filed as: LUCIDO MORRIS ASSOCIATES LLC | 24255 W 13 MILE ROAD SUITE 250 BIRMINGHAM FARMS, MI 48025 | GUARDIAN | $91 | — | $91 | 0.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANC CO EIN 59-1031071 UNRELATED COMPANY | Claims processing; Non-monetary compensation; Other services; Float revenue; Participant communication; Named fiduciary; Contract Administrator; Direct payment from the plan Service code 12 | 440 POLARIS PARKWAY WESTERVILLE, OH 43082 | $47K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 UNRELATED COMPANY | Float revenue; Direct payment from the plan; Non-monetary compensation; Other services; Named fiduciary; Contract Administrator; Claims processing; Participant communication Service code 12 | 440 POLARIS PARKWAY WESTERVILLE, OH 43082 | $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 | 187 | 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) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 140 | $505K |
| Dental | GUARDIAN | 187 | $130K |
| Vision | GUARDIAN | 187 | $130K |
| Life insurance | GUARDIAN | 187 | $130K |
| Long-term disability | GUARDIAN | 187 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.