| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | 125 W ORCHARD ST ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $39K | $0 | $39K | 13.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC DBA BET | 125 W ORCHARD ST ITAS, IL 60143 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 8.43% |
| SELMAN & COMPANY, LLC3 | 1 INTEGRITY PKWY CLEVELAND, OH 44143 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 3.23% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC ATTN COMMISSIOS | 1787 SENTRY PARKWAY WEST BLUE BELL, PA 19422 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $566 | $566 | 0.57% |
| RSC INSURANCE BROKERAGE INC3 | 125 W ORCHARD ST ITASCA, IL 60143 | VISION SERVICE PLAN | $849 | $0 | $849 | 6.69% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN RD STE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $20 | $0 | $20 | 0.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMINISTRATOR | Contract Administrator; Claims processing; Non-monetary compensation; Participant communication; Other services; Named fiduciary; Direct payment from the plan; Float revenue Service code 12 | — | $12K |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 86 | $301K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $99K |
| Vision | VISION SERVICE PLAN | 88 | $13K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $99K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $99K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 86 | $301K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.