| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITSCAFE.COM3 | 280 N MONTEBELLO BLVD. STE 102 MONTEBELLO, CA 90640 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $44K | $1K | $46K | 18.06% |
| BENEFITSCAFE.COM3 | 280 N. MONTEBELLO BLVD. STE 102 MONTEBELLO, CA 90640 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | $250 | $9K | 10.20% |
| BENEFITSCAFE.COM3 Filed as: BENEFITSCAFE COM | 280 N MONTEBELLO BLVD. STE 102 MONTEBELLO, CA 90640 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.90% |
| BENEFITSCAFE.COM3 Filed as: BENEFITSCAFE COM | 280 MONTEBELLO BLVD STE 102 MONTEBELLO, CA 90640 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 11.11% |
| BENEFITSCAFE.COM3 | 280 N MONTEBELLO BLVD STE 102 MONTEBELLO, CA 90640 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 11.06% |
| BENEFITSCAFE.COM3 Filed as: BENEFITSCAFE COM | 280 MONTEBELLO BLVD STE 102 MONTEBELLO, CA 90640 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $269 | — | $269 | 11.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICE | 160 GUTHRIE LANE BRENTWOOD, CA 94513 | ZURICH AMERICAN INSURANCE COMPANY | $222 | — | $222 | 14.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 PLAN ADMINISTRATOR | Non-monetary compensation; Contract Administrator; Other services; Direct payment from the plan; Float revenue; Participant communication; Claims processing; Named fiduciary Service code 12 | 900 COTTAGE GROVE RD BLOOMFIELD, CA 06002 | $11K |
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 | 118 | 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) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $252K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 94 | $88K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 94 | $88K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 109 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 109 | $12K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 109 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.