| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK BREEN3 | 12940 STATE ROAD NORTH ROYALTON, OH 44133 | CIGNA | $9K | — | $9K | 2.01% |
| MARK BREEN3 Filed as: MARK F. BREEN | 12940 STATE ROAD N ROYALTON, OH 44133 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 8.76% |
| MARK BREEN3 | 12940 STATE ROAD N ROYALTON, OH 44133 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 15.00% |
| MARK BREEN3 | 12940 STATE ROAD NORTH ROYALTON, OH 44133 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 29.84% |
| SMITH, THOMAS, CHRISTOPHER3 Filed as: SMITH, THOMAS , CHRISTOPHER | 2928 FOSTER CREIGHTON DR N ROYALTON, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $436 | $6K | 9.79% |
| MARK BREEN3 Filed as: MARK F. BREEN | 12940 STATE ROAD NORTH ROYALTON, OH 44133 | PROVIDENT LIFE AND ACCIDENT INSURANCE | $16K | — | $16K | 56.74% |
| SMITH, THOMAS, CHRISTOPHER3 Filed as: SMITH, THOMAS , CHRISTOPHER | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE | $7K | $1K | $8K | 28.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 06-0303370 CLAIM ADMINISTRATION | Participant communication; Named fiduciary; Non-monetary compensation; Float revenue; Other services; Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $203K |
| MARK BREEN INSURANCE AGENT\BROKER | Other fees Service code 99 | 12940 STATE ROAD NORTH ROYALTON, OH 44133 | $38K |
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 | 716 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 716 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA | 716 | $470K |
| Vision | CIGNA | 716 | $470K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 525 | $170K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 525 | $79K |
| Stop-loss / reinsurancereinsurance | CIGNA | 716 | $470K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 525 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 716 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.