| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: BOWEN MICLETTE & BRITT INS AGY | 1111 NORTH LOOP WEST SUITE 400 HOUSTON, TX 77008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $198 | — | $198 | 0.02% |
| LOCKTON COMPANIES, LLC3 Filed as: BOWEN MICLETTE & BRITT INS AGY | 2800 NORTH LOOP W STE 1100 HOUSTON, TX 770928825 | AMERITAS LIFE INSURANCE CORP | $25K | — | $25K | 10.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 300 CORPORATE CENTER DR. STE 306 CAMP HILL, PA 17011 | AMERITAS LIFE INSURANCE CORP | $12K | — | $12K | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DR. CTR II STE 305 ELMWOOD PARK, NJ 07407 | THE HARTFORD GROUP BENEFITS DIVISION | $11K | $4K | $16K | 22.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CLAIM ADMINISTRATOR | Float revenue; Other services; Named fiduciary; Participant communication; Claims processing; Non-monetary compensation; Contract Administrator; Direct payment from the plan Service code 12 | — | $508K |
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 | 555 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 555 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 684 | $1.6M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 684 | $1.6M |
| Life insurance | THE HARTFORD GROUP BENEFITS DIVISION | 336 | $71K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 555 | $1.3M |
| Other | THE HARTFORD GROUP BENEFITS DIVISION | 336 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 684 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.