| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FM FINANCIAL SERVICES INCORPORATED3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $0 | $2K | 0.29% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS, CORP. | 2677 ROCHELLE PLACE SIMI VALLEY, CA 93063 | THE GUARDIAN LIFE INSURANCE CO. OF AMERICA | $15K | $0 | $15K | 9.48% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES INC | 2677 ROCHELLE PLACE SIMI VALLEY, CA 93063 | DELTA DENTAL OF NEW JERSEY, INC. | $4K | $0 | $4K | 3.47% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES INC | 141 W GREEN STREET PASADENA, CA 91105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 9.09% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES INC | 141 W GREEN STREET PASADENA, CA 91105 | UNUM LIFE INSURANCE CO. OF AMERICA | $3K | $0 | $3K | 15.89% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES INC | 141 W GREEN STREET PASADENA, CA 91105 | UNUM LIFE INSURANCE CO. OF AMERICA | $3K | $0 | $3K | 16.09% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES | 4634 GULFSTARR DRIVE DESTIN, FL 32541 | VISION SERVICE PLAN | $952 | $0 | $952 | 6.44% |
| GRIFFIN, STEVEN, RAY3 | STE 1400 2000 MORRIS AVENUE BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $475 | $0 | $475 | 11.59% |
| GRIFFIN, STEVEN, RAY3 | STE 1400 2000 MORRIS AVENUE BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $117 | $0 | $117 | 3.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | DBA CBA 2000 MORRIS AVE., STI 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $95 | $0 | $95 | 2.63% |
| WILLIAM FRENCH3 Filed as: WILLIAM THOMAS FRENCH | 141 W GREEN STREET PASADENA, CA 91105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29 | $0 | $29 | 0.80% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES INC | 141 W GREEN STREET PASADENA, CA 91105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24 | $0 | $24 | 0.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $107K |
| WEX HEALTH INC. EIN 06-1593514 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $1K |
| CIGNA | Other services Service code 49 | — | $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 | 222 | 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) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE CO. OF AMERICA | 388 | $282K |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE CO. OF AMERICA | 388 | $169K |
| Life insurance(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE CO. OF AMERICA | 388 | $210K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE CO. OF AMERICA | 388 | $190K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE CO. OF AMERICA | 388 | $171K |
| Stop-loss / reinsurancereinsurance(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 154 | $830K |
| Other(6 contracts, 4 carriers) | THE GUARDIAN LIFE INSURANCE CO. OF AMERICA | 388 | $235K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 388 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.