| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INNOVO BENEFITS GROUP3 Filed as: INNOVO BENEFITS GROUP, LLC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $136K | — | $136K | 13.77% |
| INNOVO BENEFITS GROUP3 Filed as: INNOVO BENEFITS GROUP LLC | — | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 4.59% |
| COMPSYCH5 | — | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 1.05% |
| IMG5 | — | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $77 | $77 | 0.03% |
| INNOVO BENEFITS GROUP3 Filed as: INNOVO BENEFITS GROUP LLC | — | VISION SERVICE PLAN | $637 | — | $637 | 2.49% |
| DONALD C SAVOY INC3 | — | VISION SERVICE PLAN | $603 | — | $603 | 2.36% |
| GALLAGHER BENEFIT SERVICES, INC.0 Filed as: RISK PLACEMENT SERVICES | — | VISION SERVICE PLAN | $34 | — | $34 | 0.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 INSURANCE COMPANY | Float revenue; Contract Administrator; Named fiduciary; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $53K |
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 | 420 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 422 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 316 | $985K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 316 | $985K |
| Vision | VISION SERVICE PLAN | 251 | $26K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 420 | $253K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 420 | $253K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 420 | $253K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 420 | — |
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.