| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $78K | $104K | $182K | 59.11% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 DB EB OPERATING ACCOUNT PASADENA, CA 91109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 DB EB OPERATING ACCOUNT PASADENA, CA 91109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | STE 300 1125 SANCTUARY PKWY ALPHARETTA, GA 30009 | UNUM INSURANCE COMPANY | $2K | $311 | $2K | 16.37% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 DB EB OPERATING ACCOUNT PASADENA, CA 91109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | STE 300 1125 SANCTUARY PKWY ALPHARETTA, GA 30009 | UNUM INSURANCE COMPANY | $2K | $215 | $2K | 17.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | STE 300 1125 SANCTUARY PKWY ALPHARETTA, GA 30009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 15.54% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC.- HQ | 10TH FLOOR 18100 VON KARMAN AVE IRVINE, CA 92162 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $70 | $70 | 0.83% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 DB EB OPERATING ACCOUNT PASADENA, CA 91109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $562 | — | $562 | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.4 Filed as: ALLIANT INSURANCE SERVICES | FL 6 701 B ST SAN DIEGO, CA 92101 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $480 | — | $480 | 19.68% |
| ALLIANT INSURANCE SERVICES, INC.4 Filed as: ALLIANT INSURANCE SERVICES I | FL 6 701 B ST SAN DIEGO, CA 92101 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $336 | — | $336 | 34.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSING | Claims processing Service code 12 | — | $32K |
| CIGNA | Claims processing; Contract Administrator; Float revenue; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan; Other services Service code 12 | — | $0 |
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 119 | $308K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 119 | $308K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 119 | $308K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $26K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $12K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $25K |
| Other(6 contracts, 4 carriers) | UNUM INSURANCE COMPANY | 139 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.