| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN M KENNEDY3 | 6726 ENGLE LAKE DR LAKELAND, FL 33813 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 0.18% |
| DAVID SHORE3 | 1300 CONCORD TERRACE 5TH FLOOR SUNRISE, FL 33323 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 0.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 TPA | Contract Administrator; Named fiduciary; Direct payment from the plan; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | — | $127K |
| DAVID SHORE AGENT | Insurance agents and brokers Service code 22 | 1300 CONCORD TERRACE 5TH FLOOR SUNRISE, FL 33323 | $46K |
| JOHN M KENNEDY AGENT | Insurance agents and brokers Service code 22 | 6726 ENGLE LAKE DR LAKELAND, FL 33813 | $46K |
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 | 186 | 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) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 260 | $751K |
| Life insurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 260 | $751K |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 260 | $751K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.