| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROOM FINANCIAL GROUP3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $14K | — | $14K | 10.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMIN | Contract Administrator; Other services; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan Service code 12 | — | $37K |
| GROOMS FINANCIAL GROUP BROKER | Insurance agents and brokers Service code 22 | 2002 N LOIS AVE SUITE 160 TAMPA, FL 33607 | $6K |
| CIGNA HEALTH AND LIFE INS CO | Claims processing; Float revenue; Other services; Participant communication; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | — | $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 | 80 | 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) | 80 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 102 | $133K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 102 | $133K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 102 | $133K |
| Life insurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 102 | $133K |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 102 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 102 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.