| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANIEL DUGAN3 | 1826 ELM HILL PIKE NASHVILLE, TN 37210 | HCC LIFE INSURANCE COMPANY | $55K | — | $55K | 15.00% |
| NORTH AMERICA ADMINISTRATORS, LP5 Filed as: NORTH AMERICAN ADMINISTRATORS | 1826 ELM HILL PIKE NASHVILLE, TN 37210 | HCC LIFE INSURANCE COMPANY | — | $3K | $3K | 0.84% |
| NORTH AMERICA ADMINISTRATORS, LP5 Filed as: NORTH AMERICAN ADMINISTRATORS | 3600 ROUTE 66 NEPTUNE, NJ 07754 | AIG BENEFIT SOLUTION | $2K | — | $2K | 10.00% |
| ROSS & YERGER INSURANCE INC3 Filed as: ROSS & YERGER INSURANCE | P O BOX 1139 JACKSON, MS 39215 | CIGNA GROUP INSURANCE | $2K | $176 | $3K | 16.10% |
| ROSS & YERGER INSURANCE INC3 Filed as: ROSS & YERGER INSURANCE | PO BOX 1139 JACKSON, MS 39215 | CIGNA GROUP INSURANCE | $2K | $218 | $2K | 16.84% |
| ROSS & YERGER INSURANCE INC3 Filed as: ROSS & YERGER INSURANCE | P O BOX 1139 JACKSON, MS 39215 | CIGNA GROUP INSURANCE | $165 | $20 | $185 | 16.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 | Contract Administrator Service code 13 | PO BOX 20643 LEHIGH VALLEY, PA 180020643 | $21K |
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 | 166 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | CIGNA GROUP INSURANCE | 0 | $12K |
| Short-term disability | CIGNA GROUP INSURANCE | 0 | $1K |
| Long-term disability | CIGNA GROUP INSURANCE | 0 | $16K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 160 | $367K |
| Other | AIG BENEFIT SOLUTION | 166 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.