| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH INC | 1600 WEST 7TH STREET FORT WORTH, TX 76102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.08% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH, INC. | 1600 W 7TH ST FORT WORTH, TX 76102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 16.37% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH | 1600 WEST 7TH STREET FORT WORTH, TX 76102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 16.45% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH | 1600 WEST 7TH STREET FORT WORTH, TX 76102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $229 | $5K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CONTRACT ADMINISTRATOR | Participant communication; Other services; Float revenue; Named fiduciary; Claims processing; Direct payment from the plan; Non-monetary compensation; Contract Administrator Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $1.2M |
| CIGNA | Float revenue; Direct payment from the plan; Named fiduciary; Claims processing; Non-monetary compensation; Other services; Contract Administrator; Copying and duplicating; Participant communication Service code 12 | — | $0 |
| CIGNA HEALTH AND LIFE INSURANCE CO | Named fiduciary; Contract Administrator; Float revenue; Participant communication; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan Service code 12 | — | $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 | 1,260 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 30 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY & AFFILIATES | 532 | $3.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY & AFFILIATES | 532 | $3.7M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,373 | $173K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 260 | $28K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 132 | $176K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY & AFFILIATES | 532 | $3.7M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,373 | $227K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,373 | — |
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.