| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | PO BOX 9375 GREENSBORO, NC 27429 | CIGNA | $11K | — | $11K | 1.35% |
| MARSH & MCLENNAN AGENCY LLC Filed as: MARSH & MCLENNAN AGENCY | PO BOX 419814 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $4K | $16K | 15.89% |
| MARSH & MCLENNAN AGENCY LLC Filed as: MARSH & MCLENNAN AGENCY | PO BOX 419814 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $3K | $11K | 15.89% |
| MARSH & MCLENNAN AGENCY LLC Filed as: MARSH & MCLENNAN AGENCY | PO BOX 419814 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $2K | $7K | 15.56% |
| MARSH & MCLENNAN AGENCY LLC Filed as: MARSH & MCLENNAN AGENCY | PO BOX 419814 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $611 | $3K | 15.73% |
| PIERCE, DWIGHT, L3 Filed as: PIERCE,DWIGHT BENEFITS TECHNOLOGIES | 1200 E TAFT AVE SAPULPA, OK 74066 | PROVIDENT LIFE & ACCIDENT INSURANCE CO | $270 | — | $270 | 2.23% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 250 PEHLE AVE W #400 SADDLE BROOK, NJ 07663 | PROVIDENT LIFE & ACCIDENT INSURANCE CO | $257 | — | $257 | 2.13% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | PO BOX 9375 GREENSBORO, NC 27429 | PROVIDENT LIFE & ACCIDENT INSURANCE CO | $144 | — | $144 | 1.19% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 250 PEHLE AVE W #400 SADDLE BROOK, NJ 07663 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $403 | — | $403 | 7.85% |
| DWIGHT L PIERCE3 | 1200 E TAFT AVE SAPULPA, OK 74066 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $119 | — | $119 | 2.32% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | PO BOX 9375 GREENSBORO, NC 274290375 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $51 | — | $51 | 0.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS CO EIN 59-1031071 CIGNA PROVIES CLAIM ADMIN | Contract Administrator; Non-monetary compensation; Claims processing; Named fiduciary; Participant communication; Other services; Direct payment from the plan; Float revenue Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $114K |
| SENN DUNN INSURANCE EIN 56-2228429 | Contract Administrator Service code 13 | PO BOX 9375 GREENSBORO, NC 27429 | $40K |
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 | 308 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 308 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA | 594 | $790K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 517 | $28K |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 335 | $132K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 335 | $69K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 185 | $48K |
| Stop-loss / reinsurancereinsurance | CIGNA | 594 | $790K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 16 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 594 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.