| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOYCE M PURSELLEY3 Filed as: JOYCE M. PURSELLY | 4644 E FM 1187 BURLESON, TX 76028 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $52K | — | $52K | 9.26% |
| JOYCE M PURSELLEY3 Filed as: JOYCE PURSELLEY | 4644 E FM 1187 BURLESON, TX 76028 | UNION SECURITY INSURANCE COMPANY | $11K | — | $11K | 9.95% |
| JOYCE M PURSELLEY3 | 4644 E FM 1187 BURLESON, TX 76028 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 CONTRACT ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Non-monetary compensation; Named fiduciary; Participant communication; Float revenue; Claims processing; Other services Service code 12 | — | $55K |
| CIGNA HEALTH & LIFE INSURANCE CO | Other services; Contract Administrator; Participant communication; Non-monetary compensation; Direct payment from the plan; Claims processing; Float revenue; Named fiduciary Service code 12 | — | $0 |
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 | 163 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 163 | $563K |
| Dental | UNION SECURITY INSURANCE COMPANY | 107 | $111K |
| Life insurance(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 136 | $120K |
| Other(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 136 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.