| 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 | $181K | $311K | $492K | 80.32% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 CONTRACT ADMINISTRATOR | Non-monetary compensation; Claims processing; Contract Administrator; Float revenue Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $92K |
| AMPLIFON HEARING HEALTHCARE EIN 85-0437037 CLAIM PROCESSING | Claims processing; Other services; Participant communication; Direct payment from the plan; Contract Administrator; Named fiduciary Service code 12 | FIFTH STREET TOWERS 150 SOUTH 5TH S MINNEAPOLIS, MN 55402 | $0 |
| OMADA HEALTH, INC. EIN 45-2355015 | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator 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 | 404 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 404 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 404 | $613K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 404 | $613K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 404 | $613K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 404 | — |
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."
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.