| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUCK CONSULTANTS LLC3 | P.O. BOX 202617 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 4.80% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | P.O. BOX 905494 SUITE 400 CHARLOTTE, NC 28290 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 4.19% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $827 | $2K | 2.52% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | P.O. BOX 905494 SUITE 400 CHARLOTTE, NC 28290 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS. CO. EIN 59-1031071 NONE | Claims processing; Contract Administrator; Direct payment from the plan; Non-monetary compensation; Float revenue; Participant communication; Other services Service code 12 | — | $1.3M |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Claims processing; Contract Administrator Service code 12 | — | $76K |
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 | 2,191 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 19 | $319K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 19 | $319K |
| Vision(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 3,666 | $338K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,199 | $2.2M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,199 | $2.1M |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 19 | $319K |
| Other(6 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 3,489 | $532K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,666 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.