| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN WESTBROOK INS SERVICES LLC Filed as: AMERICAN WESTBROOK INS SERVICE LLC | FOUR WESTBROOK CORPORATE CENTER SUITE 500 WESTCHESTER, IL 60154 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $53K | — | $53K | 9.00% |
| MILLENNIUM CORPORATE SOLUTIONS Filed as: MILLENNIUM BENEFITS INC | 799 ROOSEVELT ROAD BUILDING 6 SUITE 107 GLEN ELLYN, IL 60137 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $45K | $45K | 7.60% |
| MICHAEL E SULLIVAN3 | 1605 W COLONIAL PKWY INVERNESS, IL 60067 | PRINCIPAL LIFE INSURANCE COMPANY | $14K | — | $14K | 12.44% |
| AMERICAN WESTBROOK INS SERVICES LLC Filed as: AMERICAN WESTBROOK INS SVCS | FOUR WESTBROOK CORPORATE CENTER SUITE 500 WESTCHESTER, IL 60154 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $3K | $10K | 20.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS COMPANY EIN 59-1031071 SERVICE PROVIDER | Non-monetary compensation; Float revenue; Participant communication; Direct payment from the plan; Named fiduciary; Claims processing; Contract Administrator; Other services Service code 12 | 900 COTTAGE GROVE ROAD HARTFORD, CT 06152 | $45K |
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 | 226 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 37 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 363 | $587K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 231 | $51K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 231 | $51K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 246 | $109K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 246 | $109K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 363 | $587K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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.