| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HERITAGE CORPORATE BENEFITS3 Filed as: HERITAGE CORPORATE BENEFITS, LLC | 2487 CEDARCREST ROAD SUITE 122 ACWORTH, GA 30101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $27K | $0 | $27K | 12.36% |
| HERITAGE CORPORATE BENEFITS3 Filed as: HERITAGE CORPORATE BENEFITS, LLC | 2487 CEDARCREST ROAD SUITE 122 ACWORTH, GA 30101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | $0 | $5K | 9.86% |
| HERITAGE CORPORATE BENEFITS3 Filed as: HERITAGE CORPORATE BENEFITS, LLC | 2487 CEDARCREST ROAD SUITE 122 ACWORTH, GA 30101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $513 | $4K | 17.08% |
| HERITAGE CORPORATE BENEFITS3 Filed as: HERITAGE CORPORATE BENEFITS, LLC | 2487 CEDARCREST ROAD SUITE 122 ACWORTH, GA 30101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| HERITAGE CORPORATE BENEFITS3 Filed as: HERITAGE CORPORATE BENEFITS, LLC | 2487 CEDARCREST ROAD SUITE 122 ACWORTH, GA 30101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $243 | $2K | 17.10% |
| HERITAGE CORPORATE BENEFITS3 Filed as: HERITAGE CORPORATE BENEFITS, LLC | 2487 CEDARCREST ROAD SUITE 122 ACWORTH, GA 30101 | VISION SERVICE PLAN | $554 | $0 | $554 | 9.12% |
| HERITAGE CORPORATE BENEFITS3 Filed as: HERITAGE CORPORATE BENEFITS, LLC | 2487 CEDARCREST ROAD SUITE 122 ACWORTH, GA 30101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $658 | $81 | $739 | 16.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CARRIER | Float revenue; Participant communication; Direct payment from the plan; Other services; Named fiduciary; Contract Administrator; Claims processing; Non-monetary compensation Service code 12 | — | $3K |
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 | 127 | 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) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 90 | $215K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 79 | $47K |
| Vision | VISION SERVICE PLAN | 56 | $6K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $4K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $15K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 48 | $12K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.