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| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS. CO. EIN 59-1031071 ADMIN. SVCS. AGREEMENT | Float revenue; Other services; Direct payment from the plan; Named fiduciary; Claims processing; Participant communication; Non-monetary compensation; Contract Administrator Service code 12 | — | $691K |
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 | 636 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 32 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 668 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,063 | $1.9M |
| Vision | VISION CARE | 325 | $46K |
| Life insurance | NY LIFE GROUP LIFE INSURANCE CO. OF NY | 595 | $194K |
| Short-term disability | NY LIFE GROUP LIFE INSURANCE CO. OF NY | 171 | $61K |
| Long-term disability | NY LIFE GROUP LIFE INSURANCE CO. OF NY | 597 | $66K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,063 | $1.9M |
| Other(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,910 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,910 | — |
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."
No prospect flags tripped on this filing.