| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE SERVICES OF ASHEVILLE3 | PO BOX 530 ASHEVILLE, NC 28802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $12K | $19K | 5.14% |
| INSURANCE SERVICES OF ASHEVILLE3 | PO BOX530 ASHEVILLE, NC 28802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $8K | $17K | 6.62% |
| INSURANCE SERVICES OFASHEVILLE3 | PO BOX 530 ASHEVILLE, NC 28802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $657 | $3K | 15.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIM ADMINISTRATION | Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Other services; Named fiduciary; Participant communication; Non-monetary compensation Service code 12 | — | $409K |
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 | 543 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 547 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 547 | $251K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 547 | $379K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,238 | $595K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 547 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,238 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.