| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IKON BENEFITS GROUP, INC.3 | 270 MUNOZ RIVERA AVE SUITE PH 1 SAN JUAN, PR 00918 | TRIPLE-S SALUD, INC. | $4K | — | $4K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 | Contract Administrator; Claims processing; Participant communication; Other services; Named fiduciary; Direct payment from the plan Service code 12 | — | $4.3M |
| CIGNA BEHAVIORAL HEALTH INC EIN 41-1648670 | Other services; Claims processing; Direct payment from the plan; Participant communication; Contract Administrator Service code 12 | — | $1.2M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 | Direct payment from the plan; Contract Administrator; Non-monetary compensation; Claims processing Service code 12 | — | $332K |
| PRICEWATERHOUSECOOPERS LLP EIN 13-4008324 | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $130K |
| TOWERS WATSON DELAWARE INC EIN 53-0181291 | Direct payment from the plan; Actuarial Service code 11 | — | $73K |
| JPMORGAN CHASE BANK NA EIN 13-4994650 | Trustee (directed); Other investment fees and expenses; Trustee (bank, trust company, or similar financial institution); Float revenue; Custodial (securities) Service code 19 | — | $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 | 5,320 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5,890 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 11,210 | 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 | 10 | $231K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 10 | $231K |
| Life insurance | AETNA LIFE INSURANCE CO. | 5,884 | $9.5M |
| Prescription drug | TRIPLE-S SALUD, INC. | 10 | $72K |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 6 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,884 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.