| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE SERVICES OF ASHEVILLE | PO BOX 530 ASHEVILLE, NC 28802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $0 | $7K | 1.79% |
| LEGACY RISK SOLUTIONS LLC | PO BOX 2976 GAINESVILLE, GA 30503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $940 | $0 | $940 | 0.24% |
| INSURANCE SERVICES OF ASHEVILLE | PO BOX 530 ASHEVILLE, NC 28802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $0 | $9K | 2.50% |
| LEGACY RISK SOLUTIONS LLC | PO BOX 2976 GAINESVILLE, GA 30503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $885 | $0 | $885 | 0.25% |
| INSURANCE SERVICES OF ASHEVILLE | PO BOX 530 ASHEVILLE, NC 28802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 9.34% |
| LEGACY RISK SOLUTIONS LLC | PO BOX 2976 GAINESVILLE, GA 30503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $678 | $0 | $678 | 2.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMINISTRATION | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Named fiduciary; Non-monetary compensation; Float revenue Service code 12 | — | $398K |
| EVERNORTH CARE SOLUTIONS , INC EIN 86-1465626 ADMIN EMP ASSISTANCE PLAN | Contract Administrator; Direct payment from the plan; Claims processing; Participant communication Service code 12 | — | $9K |
| EVERNORTH CARE SOLUTIONS, INC | Direct payment from the plan; Contract Administrator; Participant communication; Claims processing 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 | 466 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 468 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 442 | $358K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 401 | $8K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 401 | $386K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 825 | $765K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 442 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 825 | — |
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.