| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROFESSIONAL BENEFIT SERVICES, INC.3 | 599 GINGERMILL LANE LEXINGTON, KY 40509 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 0.68% |
| PROFESSIONAL BENEFIT SERVICES, INC.3 | 599 GINGERMILL LANE LEXINGTON, KY 40509 | AMERITAS LIFE INSURANCE CORP | $6K | — | $6K | 2.58% |
| TIMOTHY RAYMOND PEARSE3 | 599 GINGERMILL LANE LEXINGTON, KY 40509 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | — | $9K | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 TPA | Non-monetary compensation; Named fiduciary; Participant communication; Float revenue; Other fees; Direct payment from the plan; Contract Administrator; Other services; Claims processing Service code 12 | — | $195K |
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 | 694 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 694 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 777 | $775K |
| Dental | AMERITAS LIFE INSURANCE CORP | 1,641 | $251K |
| Life insurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 777 | $775K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 173 | $87K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 173 | $87K |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 777 | $775K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,641 | — |
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.