| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SELECT NETWORKS5 | 317 6TH AVE DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| WALLACE WELCH & WILLINGHAM INC3 | 300 1ST AVE S STE 500 PO BOX 33020 ST PETERSBURG, FL 33733 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $1K | $10K | 16.80% |
| WALLACE WELCH & WILLINGHAM INC3 | 300 1ST AVE S STE 500 PO BOX 33020 ST PETERSBURG, FL 33733 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $763 | $8K | 16.53% |
| WALLACE WELCH & WILLINGHAM INC3 | 300 1ST AVE S STE 500 PO BOX 33020 ST PETERSBURG, FL 33733 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $807 | $8K | 16.76% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 CLAIMS PROCESSING | Other services; Named fiduciary; Direct payment from the plan; Contract Administrator; Claims processing; Non-monetary compensation; Float revenue; Participant communication Service code 12 | — | $717K |
| CIGNA | Claims processing; Direct payment from the plan; Float revenue; Named fiduciary; Other services; Contract Administrator; Participant communication; Non-monetary compensation 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 | 810 | 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) | 810 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES(CIGNA) | 1,523 | $1.2M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,245 | $74K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 810 | $183K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 381 | $114K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 349 | $79K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES(CIGNA) | 1,523 | $1.2M |
| Other(6 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES(CIGNA) | 1,523 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,523 | — |
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.