| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM FRENCH3 Filed as: WILLIAM THOMAS FRENCH | 141 W GREEN STREET PASADENA, CA 91105 | AETNA LIFE INSURANCE CO | $22K | $0 | $22K | 13.39% |
| WILLIAM FRENCH3 Filed as: WILLIAM THOMAS FRENCH | 141 W GREEN STREET PASADENA, CA 91105 | DELTA DENTAL OF NJ INC. | $6K | $0 | $6K | 4.29% |
| WILLIAM FRENCH3 Filed as: WILLIAM THOMAS FRENCH | 141 W GREEN STREET PASADENA, CA 91105 | FLAGSHIP HEALTH SYSTEMS | $3K | $0 | $3K | 2.77% |
| KRAUTER AND COMPANY, LLC3 Filed as: KRAUTER AND COMPANY LLC | 150 SPEAR STREET, SUITE 800 SAN FRANCISCO, CA 94105 | FLAGSHIP HEALTH SYSTEMS | $374 | $0 | $374 | 0.31% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES INC | 141 W GREEN STREET PASADENA, CA 91105 | THE VERMONT HEALTH PLAN | $4K | $0 | $4K | 4.06% |
| WILLIAM FRENCH3 | 141 W GREEN STREET PASADENA, CA 91105 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $781K |
| CIGNA | Other services Service code 49 | — | $2K |
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 | 603 | 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. |
| Beneficiaries receiving benefits | 1 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 604 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | THE VERMONT HEALTH PLAN | 207 | $102K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NJ INC. | 237 | $259K |
| Vision(2 contracts, 2 carriers) | THE VERMONT HEALTH PLAN | 301 | $140K |
| Life insurance | AETNA LIFE INSURANCE CO | 603 | $162K |
| Short-term disability | AETNA LIFE INSURANCE CO | 603 | $162K |
| Long-term disability | AETNA LIFE INSURANCE CO | 603 | $162K |
| Prescription drug | THE VERMONT HEALTH PLAN | 207 | $102K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE CO AND AFFIL | 770 | $902K |
| Other | AETNA LIFE INSURANCE CO | 603 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 770 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.