| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFITS ADVISORS | 4823 OLD KINGSTON PIKE, SUITE 205 KNOXVILLET, TN 37919 | RELIASTAR LIFE INSURANCE COMPANY | $47K | — | $47K | 10.00% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFITS ADVISORS | 4823 OLD KINGSTON PIKE, SUITE 205 KNOXVILLET, TN 37919 | RELIASTAR LIFE INSURANCE COMPANY | $6K | — | $6K | 1.25% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFITS ADVISORS | 4823 OLD KINGSTON PIKE, SUITE 205 KNOXVILLE, TN 37919 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $12K | $12K | 4.11% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFITS ADVISORS | 4823 OLD KINGSTON PIKE, SUITE 205 KNOXVILLET, TN 37919 | SUN LIFE ASSURANCE COMPANY OF CANADA | $11K | — | $11K | 5.12% |
| UNITED BENEFIT ADVISORS LLC3 | 280 E 96TH ST, SUITE 250 INDIANAPOLIS, IN 46240 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 2.56% |
| VISION SERVICE PLAN | — | VISION SERVICE PLAN | $0 | $0 | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 CLAIMS ADMINISTRATOR | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator Service code 12 | — | $931K |
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 | 1,212 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 31 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,044 | $145K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,560 | $475K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 913 | $285K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,236 | $223K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 1,560 | $475K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,560 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.