| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN, INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $62K | $129 | $62K | 4.42% |
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN INC | 240 E LANIER AVE FAYETTEVILLE, GA 30214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | $0 | $18K | 14.97% |
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN INC | 240 E LANIER AVE FAYETTEVILLE, GA 30214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $0 | $12K | 10.00% |
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN INC | 240 E LANIER AVE FAYETTEVILLE, GA 30214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $0 | $10K | 10.00% |
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN INC | 240 E LANIER AVE FAYETTEVILLE, GA 30214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $507 | $0 | $507 | 9.99% |
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN INC | 240 E LANIER AVE FAYETTEVILLE, GA 30214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $223 | $0 | $223 | 10.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSING | Non-monetary compensation; Claims processing; Participant communication; Contract Administrator; Named fiduciary; Direct payment from the plan; Other services; Float revenue Service code 12 | — | $627K |
| RESOURCE SEVEN BROKER | Insurance agents and brokers Service code 22 | 240 EAST LANIER AVE FAYETTEVILLE, GA 30215 | $171K |
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 | 1,125 | 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) | 1,125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,125 | $1.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,125 | $1.4M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,125 | $1.4M |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 454 | $124K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 222 | $97K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 249 | $117K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,125 | $1.4M |
| Other(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,125 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,125 | — |
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.