| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AY BENEFITS LLC3 | 7500 OLD GEORGETOWN RD STE 1225 BETHESDA, MD 20814 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 1.35% |
| AY BENEFITS LLC3 | 7500 OLD GEORGETOWN RD STE 1225 BETHESDA, MD 20814 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 7.50% |
| AY BENEFITS LLC3 | 7500 OLD GEORGETOWN RD STE 1225 BETHESDA, MD 20814 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.50% |
| AY BENEFITS LLC3 | 7500 OLD GEORGETOWN RD STE 1225 BETHESDA, MD 20814 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.22% |
| AY BENEFITS LLC3 Filed as: AY BENEFITS, LLC | 7500 OLD GEORGETOWN RD 1225 BETHESDA, MD 208146808 | VISION SERVICE PLAN | $1K | — | $1K | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMINISTRATOR | Participant communication; Direct payment from the plan; Contract Administrator; Float revenue; Named fiduciary; Other services; Non-monetary compensation; Claims processing Service code 12 | — | $233K |
| AY BENEFITS LLC BROKER | Insurance agents and brokers Service code 22 | 7500 OLD GEORGETOWN RD STE 1225 BETHESDA, MD 20814 | $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 | 301 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 301 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 419 | $392K |
| Vision | VISION SERVICE PLAN | 225 | $25K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 200 | $40K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $29K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 94 | $36K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 419 | $392K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 419 | — |
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."
No prospect flags tripped on this filing.