| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29727 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AFFILIATES | — | $32K | $32K | 2.60% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILSON TOWERS WATSON SOUTHEAST INC | 233 S WACKER DR CHICAGO, IL 60606 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | — | $5K | 651.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF GA INC | CONCOURSE CORPORATE CTR FIVE FL 18 ATLANTA, GA 30328 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | -$2K | — | -$2K | -294.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 CLAIMS ADMINISTRATOR | Other services; Contract Administrator; Direct payment from the plan; Claims processing; Named fiduciary; Float revenue; Participant communication; Non-monetary compensation Service code 12 | — | $26K |
| CIGNA HEALTH AND LIFE INS COMPANY | Participant communication; Other services; Claims processing; Contract Administrator; Float revenue; Non-monetary compensation; Named fiduciary; Direct payment from the plan Service code 12 | — | $0 |
| WILLIS INSURANCE SERVICES OF GA INC BROKER | Other commissions Service code 55 | CONCOURSE CORPORATE CTR FIVE FL 18 ATLANTA, GA 30328 | $0 |
| WILLIS TOWERS WATSON SOUTHEAST INC BROKER | Other commissions Service code 55 | 233 S WACKER DR CHICAGO, IL 60606 | $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 | 183 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AFFILIATES | 149 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AFFILIATES | 149 | $1.2M |
| Vision(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AFFILIATES | 149 | $1.2M |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 0 | $734 |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 0 | $734 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 149 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.