| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $125K | $3K | $128K | 3.07% |
| MARSH & MCLENNAN AGENCY LLC3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $51K | — | $51K | 1.23% |
| MARSH & MCLENNAN AGENCY LLC3 | 8144 WALNUT HILL LANE 16TH FLOOR DALLAS, TX 75231 | HARTFORD LIFE AND ACCIDENT | $23K | $5K | $28K | 10.37% |
| MARSH & MCLENNAN AGENCY LLC3 | 100 FRONT STREET SUITE 800 WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $5K | $5K | 1.85% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY LLC-DALLAS | 8144 WALNUT HILL LANE 16TH FLOOR DALLAS, TX 75231 | HUMANA INSURANCE COMPANY | $4K | — | $4K | 9.92% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $1K | — | $1K | 20.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH | 301 COMMERCE STREET FORT WORTH, TX 76102 | FEDERAL INSURANCE COMPANY | $1K | — | $1K | 14.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MHBT | 8144 WALNUT HILL LANE 16TH FLOOR DALLAS, TX 75231 | FOUR EVER LIFE INSURANCE COMPANY | $240 | $240 | $480 | 20.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TOTAL ADMINISTRATIVE SERVICES CORPO EIN 39-1561025 NONE | Contract Administrator Service code 13 | — | $22K |
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 | 471 | 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) | 471 | 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 AND AFFILIATES | 854 | $4.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 854 | $4.2M |
| Vision | HUMANA INSURANCE COMPANY | 321 | $39K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 483 | $272K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 483 | $272K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 854 | $4.2M |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 854 | $4.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 854 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.