| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 7500 OLD GEORGETOWN ROAD, SUITE 925 BETHESDA, MD 20814 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $254K | $404K | $658K | 56.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 CONTRACT ADMINISTRATOR | Non-monetary compensation; Claims processing; Contract Administrator; Named fiduciary; Float revenue; Participant communication; Other services; Direct payment from the plan Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $58K |
| AMERICAN SPECIALTY HEALTH (ASH) EIN 33-0571188 CLAIM PROCESSING | Float revenue; Claims processing; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Other services; Contract Administrator Service code 12 | 10221 WATERIDGE CIR 201 SAN DIEGO, CA 92121 | $0 |
| AMPLIFON HEARING HEALTHCARE EIN 85-0437037 CLAIM PROCESSING | Direct payment from the plan; Named fiduciary; Participant communication; Other services; Claims processing; Non-monetary compensation; Contract Administrator; Float revenue Service code 12 | FIFTH STREET TOWERS 150 SOUTH 5TH S MINNEAPOLIS, MN 55402 | $0 |
| FIT FOR LIFE EIN 38-3983812 CLAIM PROCESSING | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator Service code 12 | 833 W SOUTH BOULDER RD. LOUISVILLE, CO 800272452 | $0 |
| OMADA HEALTH, INC. EIN 45-2355015 CLAIM PROCESSING | Named fiduciary; Participant communication; Float revenue; Claims processing; Other services; Direct payment from the plan; Contract Administrator; Non-monetary compensation Service code 12 | 500 SANSOME ST., 200 SAN FRANCISCO, CA 94111 | $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 | 394 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 394 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 394 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 394 | $1.2M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 394 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 394 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.