| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LUMITY, INC.3 Filed as: LUMITY INC | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $11K | — | $11K | 6.52% |
| ARMFIELD HARRISON & THOMAS3 | 20 S KING STREET LEESBURG, VA 20175 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | — | $6K | 3.41% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS. | 721S PARKER, SUITE 300 ORANGE, CA 92868 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $2K | $2K | 1.18% |
| LUMITY, INC.3 Filed as: LUMITY INC | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | KAISER FOUNDATION HEALTH PLAN INC | $1K | — | $1K | 2.58% |
| ARMFIELD HARRISON & THOMAS3 | 20 S KING STREET LEESBURG, VA 20175 | KAISER FOUNDATION HEALTH PLAN INC | $731 | — | $731 | 1.82% |
| LUMITY, INC.3 Filed as: LUMITY INC | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.07% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD, SUITE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $831 | $831 | 2.75% |
| ARMFIELD HARRISON & THOMAS3 | 20 S KING STREET LEESBURG, VA 20175 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $692 | — | $692 | 2.29% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 721 S PARKER ST STE 300 ORANGE, CA 92868 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $232 | $232 | 0.77% |
| LUMITY, INC.3 Filed as: LUMITY INC. | 71 EAST 3RD AVE SAN MATEO, CA 94401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 6.18% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD, SUITE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $515 | $515 | 2.80% |
| ARMFIELD HARRISON & THOMAS3 | 20 S KING STREET LEESBURG, VA 20175 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $430 | — | $430 | 2.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 721 S PARKER ST STE 300 ORANGE, CA 92868 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $144 | $144 | 0.78% |
| LUMITY, INC.3 Filed as: LUMITY INC. | 71 EAST 3RD AVE SAN MATEO, CA 94401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 6.07% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD, SUITE 300 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $487 | $487 | 2.75% |
| ARMFIELD HARRISON & THOMAS3 | 20 S KING STREET LEESBURG, VA 20175 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $404 | — | $404 | 2.28% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 721 S PARKER ST STE 300 ORANGE, CA 92868 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $135 | $135 | 0.76% |
| LUMITY, INC.3 Filed as: LUMITY INC. | 71 EAST 3RD AVE SAN MATEO, CA 94401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $358 | — | $358 | 6.20% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD, SUITE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $162 | $162 | 2.81% |
| ARMFIELD HARRISON & THOMAS3 | 20 S KING STREET LEESBURG, VA 20175 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $135 | — | $135 | 2.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 721 S PARKER ST STE 300 ORANGE, CA 92868 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $45 | $45 | 0.78% |
No Schedule C service providers reported on this filing.
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 7 | $40K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 276 | $166K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 276 | $166K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 173 | $18K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 173 | $18K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 173 | $30K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 7 | $40K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 173 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 276 | — |
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.