| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRIGHTLINE DEALER ADVISORS, LLC3 Filed as: BRIGHTLINE DEALER ADVISORS LLC | 14131 MIDWAY ROAD STE 520 ADDISON, TX 75001 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $68K | — | $68K | 12.29% |
| BRIGHTLINE DEALER ADVISORS, LLC3 Filed as: BRIGHTLINE DEALER ADVISORS LLC | 14131 MIDWAY ROAD STE 520 ADDISON, TX 75001 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 10.82% |
| BROWN & BROWN INSURANCE SERVICES3 | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.13% |
| MARK S METTILLE3 Filed as: MARK STEPHEN METTILLE | 832 BAY ST NE UNIT 1 SAINT PETERSBURG, FL 33701 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $516 | — | $516 | 0.41% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN INC | 9401 AMBERGLEN BLVD STE 100 AUSTIN, TX 78729 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | -$72 | — | -$72 | -0.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CONTRACT ADMINISTRATRO | Contract Administrator Service code 13 | — | $57K |
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 | 282 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 230 | $550K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 282 | $127K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 282 | $127K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 282 | $127K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 282 | $127K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 230 | $550K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 282 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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.