| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN, INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $72K | $0 | $72K | 4.44% |
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN INC | 240 E LANIER AVE FAYETTEVILLE, GA 30214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $24K | $0 | $24K | 15.00% |
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN INC | 240 E LANIER AVE FAYETTEVILLE, GA 30214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $0 | $13K | 10.00% |
| 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 | 240 E LANIER AVE FAYETTEVILLE, GA 30214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 8.00% |
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN INC | 240 E LANIER AVE FAYETTEVILLE, GA 30214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $538 | $0 | $538 | 10.01% |
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN INC | 240 E LANIER AVE FAYETTEVILLE, GA 30214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $237 | $0 | $237 | 10.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSING | Direct payment from the plan; Named fiduciary; Participant communication; Other services; Non-monetary compensation; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $818K |
| RESOURCE SEVEN BROKER | Insurance agents and brokers Service code 22 | 240 EAST LANIER AVE FAYETTEVILLE, GA 30215 | $197K |
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 | 1,339 | 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) | 1,339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,339 | $1.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,339 | $1.6M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,339 | $1.6M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 295 | $5K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 320 | $115K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 303 | $133K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,339 | $1.6M |
| Other(4 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,339 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,339 | — |
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.