| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: KEENAN SUGGS BOWERS ELKINS LLC | PO BOX 12739 COLUMBIA, SC 29211 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $5 | $1K | 2.48% |
| LAYNE FINANCIAL INC3 | 315 GREEN RIDGE RD STE H1 NEW CASTLE, PA 161056145 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 2.47% |
| SENN DUNN INSURANCE3 Filed as: SENN DUNN INS | 3625 N ELM STREET GREENSBORO, NC 27455 | PHYSICIANS EYECARE PLAN | $2K | — | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Other services; Contract Administrator; Direct payment from the plan Service code 12 | — | $61K |
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 | 413 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 413 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 0 | $0 |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 437 | $41K |
| Vision(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 437 | $62K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE COMPANY | 413 | $420K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 437 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.