| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP SOUTHEAST, LLC | 4211 W BOYSCOUT BLVD STE 800 TAMPA, FL 33607 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $746 | $746 | 0.44% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 N PARK DRIVE STE 200 HUNT VALLEY, MD 21030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $7K | $14K | 11.86% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 2910 W BAY TO BAY BLVD TAMPA, FL 33629 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 4.19% |
| ACCRETIVE SPECIALTY INS SOLUTIONS3 | 2910 BAY TO BAY BLVD. TAMPA, FL 33629 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $712 | — | $712 | 8.36% |
| ACCRETIVE SPECIALTY INS SOLUTIONS3 | 2910 BAY TO BAY BLVD. TAMPA, FL 33629 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $594 | — | $594 | 8.40% |
| ACCRETIVE SPECIALTY INS SOLUTIONS3 | 2910 BAY TO BAY BLVD. TAMPA, FL 33629 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $558 | — | $558 | 8.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 MEDICAL ADMIN FEES | Contract Administrator; Claims processing Service code 12 | — | $231K |
| CIGNA | Non-monetary compensation; Contract Administrator; Float revenue; Claims processing; Named fiduciary; Direct payment from the plan; Participant communication; Other services Service code 12 | — | $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 | 270 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 240 | $170K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 270 | $120K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 270 | $120K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 270 | $120K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 270 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.