| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC. | PO BOX 3716 NORFOLK, VA 235143716 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.85% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 1820 E. FIRST ST. STE 400 SANTA ANA, CA 92705 | RELIASTAR LIFE INSURANCE COMPANY | $11K | $0 | $11K | 45.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | RELIASTAR LIFE INSURANCE COMPANY | $5K | $0 | $5K | 19.41% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS, INC. | 233 SOUTH WACKER DRIVE CHICAGO, IL 60606 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $236 | $0 | $236 | 1.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS HRH - ILLINOIS | 233 SOUTH WACKER DRIVE CHICAGO, IL 60606 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $157 | $0 | $157 | 0.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMINISTRATION | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Other services; Contract Administrator; Direct payment from the plan Service code 12 | A CIGNA COMPANY HARTFORD, CT 06152 | $207K |
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 | 651 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 651 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | RELIASTAR LIFE INSURANCE COMPANY | 100 | $24K |
| Dental | HEALTH CARE SERVICE CORPORATION | 651 | $210K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 50 | $22K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $126K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $126K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $126K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 571 | $399K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 651 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.