| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AUGUST BENEFITS INC3 Filed as: AUGUST BENEFITS, INC. | 769 NEW YORK AVENUE HUNTINGTON, NY 11788 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $23K | — | $23K | 3.73% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, 2ND FLOOR HAUPPAGE, NY 11788 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $13K | $13K | 2.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $12K | — | $12K | 1.92% |
| AUGUST BENEFITS INC3 Filed as: AUGUST BENEFITS, INC. | 769 NEW YORK AVENUE HUNTINGTON, NY 11743 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 3.67% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 1.23% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 4175 S. RILEY STREET, SUITE 200 LAS VEGAS, NV 89147 | HEALTH PLAN OF NEVADA | $6K | — | $6K | 5.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 NORTH SCOTTSDALE DRIVE SUITE 600 SCOTTSDALE, AZ 85254 | HEALTH PLAN OF NEVADA | $1K | — | $1K | 1.00% |
| ENROLLEASE3 Filed as: THE KNW GROUP, LLC | 4350 BAKER ROAD, SUITE 250 MINNETOKA, MN 55343 | BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $2K | — | $2K | 2.95% |
| JOHN J SITARZ3 Filed as: JOHN J. SITARZ | 11100 WAYZATA BOULEVARD, SUITE 405 MINNETONKA, MN 55305 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 7.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | 525 MARKET STREET, 34TH FLOOR SAN FRANCISCO, CA 94105 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.46% |
| TODD BELLISTRI3 Filed as: TODD C. BELLISTRI | 769 NEW YORK AVENUE HUNTINGTON, NY 11743 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $471 | — | $471 | 1.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $205 | — | $205 | 0.81% |
No Schedule C service providers reported on this filing.
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 | 103 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 103 | $1.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 103 | $604K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 103 | $604K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 122 | $51K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 122 | $51K |
| Prescription drug(5 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 103 | $1.0M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 122 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.