| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $34 | $34 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $34 | $34 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 NONE | Contract Administrator; Claims processing Service code 12 | 501 US HIGHWAY 22 2ND FLOOR - WEST BRIDGEWATER, NJ 08807 | $55K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMINISTRATION | Claims processing; Contract Administrator; Participant communication; Direct payment from the plan; Non-monetary compensation; Other services; Float revenue; Named fiduciary Service code 12 | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | $52K |
| CIGNA HEALTH AND LIFE INSURANCE | Contract Administrator; Direct payment from the plan; Named fiduciary; Non-monetary compensation; Claims processing; Float revenue; Participant communication; Other services Service code 12 | — | $0 |
| CIGNA HEALTH AND LIFE INSURANCE CO. | Non-monetary compensation; Contract Administrator; Other services; Claims processing; Named fiduciary; Float revenue; Participant communication; Direct payment from the plan Service code 12 | — | $0 |
| EVERNORTH BEHAVIORAL HEALTH INC EIN 41-1648670 16006 | Contract Administrator; Claims processing; Participant communication Service code 12 | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | $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 | 508 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 527 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,488 | $539K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,488 | $539K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,119 | $876K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,119 | $876K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,488 | $539K |
| Other(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,488 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,488 | — |
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.