| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95148 CHICAGO, IL 60694 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $59K | $61K | 2.30% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: MERIDIAN RISK MANAGEMENT | PO BOX 8419 PELHAM, NY 10803 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | $39K | $40K | 1.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, STE 1000 LOCKBOX 95287 ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $526 | $526 | 0.02% |
| JEREMY S. SAUVE3 Filed as: JEREMY S SAUVE | 705 CUR LEE LANE BOILING SPRINGS, PA 17007 | HIGHMARK INC. | $4K | — | $4K | 2.20% |
| THOMAS CLEMENTS3 | 61 STILLMAN STREET FAIRFIELD, CT 06824 | HIGHMARK INC. | $2K | — | $2K | 1.10% |
| THE BENECON GROUP3 Filed as: THE BENECON GROUP LLC | PO BOX 5406 LANCASTER, PA 17606 | HIGHMARK INC. | $1K | — | $1K | 0.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 12750 MERIT DRIVE, SUITE 1000 PARK CENTRAL 7 DALLAS, TX 75251 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $6K | $12K | 6.99% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: MERIDIAN RISK MANAGEMENT INC. | ONE WOLFS LANE PELHAM, NY 10803 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 3.36% |
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 | 218 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 287 | $2.8M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 287 | $2.8M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 287 | $2.6M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $172K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $172K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 287 | $2.8M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $172K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.