| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $236 | $78K | $78K | 1.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $46K | $46K | 0.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 702 KING FARM BOULEVARD, SUITE 210 ROCKVILLE, NY 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $43K | $0 | $43K | 10.10% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL IBC, LLC | 32 OLD SLIP NEW YORK, NY 10005 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $26K | $0 | $26K | 5.98% |
| ALLIANT INSURANCE SERVICES, INC.3 | 32 OLD SLIP NEW YORK, NY 10005 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | $3K | $20K | 4.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 702 KING FARM BOULEVARD, SUITE 210 ROCKVILLE, MD 20850 | DELTA DENTAL OF VIRGINIA | $8K | $0 | $8K | 2.53% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | DELTA DENTAL OF VIRGINIA | $8K | $0 | $8K | 2.47% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 6.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 702 KING FARM BOULEVARD, SUITE 210 ROCKVILLE, MD 20850 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.44% |
No Schedule C service providers reported on this filing.
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 | 443 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 443 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 453 | $5.4M |
| Dental | DELTA DENTAL OF VIRGINIA | 863 | $331K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 728 | $44K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 443 | $430K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 443 | $430K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 443 | $430K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 453 | $5.4M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 443 | $430K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 863 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.