| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY, SUITE 300 DEER PARK, IL 60010 | AETNA LIFE INSURANCE CO. | — | $18 | $18 | 0.01% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY, SUITE 300 DEER PARK, IL 60010 | AETNA LIFE INSURANCE CO. | — | $3K | $3K | 0.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 ADMINISTRATOR | Named fiduciary; Direct payment from the plan; Contract Administrator; Other services; Participant communication; Float revenue; Non-monetary compensation; Claims processing Service code 12 | — | $888K |
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 | 1,150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 320 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,470 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 86 | $532K |
| Dental(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,161 | $1.0M |
| Vision | EYEMED VISION | 1,473 | $61K |
| Life insurance | AETNA LIFE INSURANCE CO. | 2,225 | $313K |
| Short-term disability | AETNA LIFE INSURANCE CO. | 2,096 | $325K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 747 | $61K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,161 | $854K |
| Other(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,161 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,225 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.