| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RISK STRATEGIES COMPANY3 | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $43K | $0 | $43K | 4.00% |
| STACY BRYANT3 | 6285 EAST SPRING STREET, BOX 273 LONG BEACH, CA 90808 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | $0 | $5K | 0.44% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 177 CRANBROKK DRIVE HOLDEN, MA 01520 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 8.19% |
| STACY BRYANT3 | 6285 EAST SPRING STREET LONG BEACH, CA 90808 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $256 | $0 | $256 | 0.55% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $224 | $224 | 0.48% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $563 | $0 | $563 | 6.79% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $113 | $0 | $113 | 1.36% |
| STACY BRYANT3 Filed as: STACY A. BRYANT | 3291 LAMA AVENUE LONG BEACH, CA 90808 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $55 | $0 | $55 | 0.66% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | $0 | $1K | 17.38% |
| THE BALDWIN GROUP WEST LLC3 Filed as: BALDWIN GROUP WEST, LLC | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $84 | $0 | $84 | 1.21% |
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 | 131 | 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) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 77 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 77 | $1.1M |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 133 | $8K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $47K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $47K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 77 | $1.1M |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 131 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.