| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE, SUITE 3400 CHICAGO, IL 60661 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $7K | $7K | 1.60% |
| WORTHAM SAN ANTONIO INC4 Filed as: WORTHAM-FORT WORTH INC. | 1600 W. 7TH STREET FORT WORTH, TX 76102 | LEGALSHIELD | $320 | — | $320 | 2.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 ADMINISTRATOR | Other services; Contract Administrator; Direct payment from the plan; Claims processing; Named fiduciary; Float revenue; Participant communication; Non-monetary compensation Service code 12 | — | $487K |
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 | 1,654 | 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) | 1,654 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,654 | $668K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,654 | $456K |
| Vision | VISION SERVICE PLAN | 762 | $94K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,131 | $178K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 903 | $52K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 12 | $42K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,654 | $456K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,654 | $456K |
| Other | LEGALSHIELD | 85 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,654 | — |
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.