| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BIJAN NAHAI3 | 465 S. BEVERLY DRIVE, SUITE 200 BEVERLY HILLS, CA 90212 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | $0 | $9K | 9.93% |
| BIJAN NAHAI3 | 465 S. BEVERLY DRIVE, SUITE 200 BEVERLY HILLS, CA 90212 | CIGNA DENTAL HEALTH OF TEXAS, INC. | $912 | $0 | $912 | 10.00% |
| BIJAN NAHAI3 | 465 S. BEVERLY DRIVE, SUITE 200 BEVERLY HILLS, CA 90212 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $724 | $0 | $724 | 10.00% |
| BIJAN NAHAI3 | 465 S. BEVERLY DRIVE, SUITE 200 BEVERLY HILLS, CA 90212 | CIGNA DENTAL HEALTH OF FLORIDA, INC. | $717 | $0 | $717 | 10.00% |
| BIJAN NAHAI3 | 465 S. BEVERLY DRIVE, SUITE 200 BEVERLY HILLS, CA 90212 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $602 | $0 | $602 | 10.00% |
| BIJAN NAHAI3 | 465 S. BEVERLY DRIVE,SUITE 200 BEVERLY HILLS, CA 90212 | CIGNA DENTAL HEALTH PLAN OF ARIZONA, INC. | $43 | $0 | $43 | 9.93% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $30K |
| BIJAN NAHAI EIN 95-4734400 INSURANCE BROKER | Insurance agents and brokers Service code 22 | 465 S. BEVERLY DRIVE, SUITE 200 BEVERLY HILLS, CA 90212 | $28K |
| CIGNA HEALTH & LIFE INSURANCE CO. | Direct payment from the plan; Named fiduciary; Claims processing; Other services; Participant communication; Float revenue; Non-monetary compensation; Contract Administrator Service code 12 | — | $0 |
| CIGNA HEALTH AND LIFE INSURANCE CO. | Named fiduciary; Participant communication; Non-monetary compensation; Float revenue; Claims processing; Direct payment from the plan; Contract Administrator; 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 | 206 | 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) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 121 | $0 |
| Dental(5 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 125 | $118K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 125 | $95K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 206 | $7K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 121 | $0 |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 206 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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.