| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NEFOUSE & ASSOCIATES, INC.3 | 8435 KEYSTONE CROSSING SUITE 160 INDIANAPOLIS, IN 462404354 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $99K | — | $99K | 3.98% |
| NEFOUSE & ASSOCIATES, INC.3 | 8435 KEYSTONE CROSSING SUITE 160 INDIANAPOLIS, IN 462404354 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 4.26% |
| NEFOUSE & ASSOCIATES, INC.3 | 8435 KEYSTONE CROSSING SUITE 160 INDIANAPOLIS, IN 462404354 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 13.96% |
| NEFOUSE & ASSOCIATES, INC.3 | 8435 KEYSTONE CROSSING SUITE 160 INDIANAPOLIS, IN 462404354 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 20.18% |
| NEFOUSE & ASSOCIATES, INC.3 | 8435 KEYSTONE CROSSING SUITE 160 INDIANAPOLIS, IN 462404354 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $962 | $7K | 15.95% |
| NEFOUSE & ASSOCIATES, INC.3 | 8435 KEYSTONE CROSSING SUITE 160 INDIANAPOLIS, IN 462404354 | VISION SERVICE PLAN | $2K | — | $2K | 3.96% |
| NEFOUSE & ASSOCIATES, INC.3 | 8435 KEYSTONE CROSSING SUITE 160 INDIANAPOLIS, IN 462404354 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $454 | $4K | 15.66% |
| NEFOUSE & ASSOCIATES, INC.3 | 8435 KEYSTONE CROSSING SUITE 160 INDIANAPOLIS, IN 462404354 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 14.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CLAIMS ADMINISTRATOR | Named fiduciary; Contract Administrator; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Float revenue; Participant communication Service code 12 | 280 TRUMBALL ST #5 HARTFORD, CT 06103 | $11K |
| EVERNORTH BEHAVORIAL HEALTH, INC. EIN 41-1648670 EMPLOYEE ASSISTANCE | Claims processing; Participant communication; Direct payment from the plan; Contract Administrator Service code 12 | 280 TRUMBALL ST #5 HARTFORD, CT 06103 | $6K |
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 | 320 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 240 | $2.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 240 | $2.5M |
| Vision | VISION SERVICE PLAN | 310 | $43K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 308 | $60K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 308 | $121K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 240 | $2.5M |
| Other(6 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 320 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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.