| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PARKWAY, SUITE 300 ALPHARETTA, GA 30004 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $8K | $0 | $8K | 6.28% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91109 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | $0 | $5K | 3.70% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1120 SANCTUARY PARKWAY, SUITE 300 ALPHARETTA, GA 30004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 7.68% |
| ALLIANT INSURANCE SERVICES, INC.3 | 3424 PEACHTREE ROAD NE SUITE 1400 ATLANTA, GA 30326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 5.56% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOCIATES | 2338 IMMOKALEE ROAD, SUITE 240 NAPLES, FL 34110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$5 | $1K | $1K | 1.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 1411 OPUS PLACE, SUITE 450 DOWNERS GROVE, IL 60515 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $345 | $345 | 0.54% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $40 | $40 | 0.06% |
| UNKNOWN3 | UNKNOWN ATLANTA, GA 30339 | MAXORPLUS | $9K | $0 | $9K | 55.21% |
No Schedule C service providers reported on this filing.
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 | 180 | 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) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 119 | $129K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 119 | $129K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 180 | $63K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 180 | $63K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 180 | $63K |
| Prescription drug | MAXORPLUS | 242 | $16K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 180 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.