| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IL 60006 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $0 | $264 | $264 | 1.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IL 60006 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $0 | $190 | $190 | 1.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SER | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SUNLIFE AND HEALTH INSURANCE CO (US) | $94 | $0 | $94 | 1.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IL 60006 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $0 | $19 | $19 | 1.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Other services; Claims processing; Participant communication; Float revenue; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Contract Administrator Service code 12 | — | $36K |
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 | 181 | 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) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 188 | $1.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 113 | $88K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 110 | $8K |
| Life insurance(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 181 | $23K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 51 | $23K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 188 | $1.3M |
| Other(3 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 181 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.