| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TSE, EDDY M3 Filed as: TSE FINANCIAL SERVICES | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $26K | — | $26K | 11.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 1.31% |
| THEODORE EBNER3 | 7821 SILVERTHREAD LANE RALEIGH, NC 27617 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$203 | — | -$203 | -0.09% |
| THEODORE EBNER3 Filed as: THEODORE S EBNER | 7821 SILVERTHREAD LANE RALEIGH, NC 27617 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 20.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $915 | — | $915 | 2.63% |
| MARK S METTILLE3 Filed as: MARK STEPHEN METTILLE | 832 BAY STREET NE UNIT 1 SAINT PETERSBURG, FL 33701 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $340 | — | $340 | 0.98% |
No Schedule C service providers reported on this filing.
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 | 84 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 85 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 100 | $221K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $35K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $35K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $35K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $35K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $35K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 100 | $221K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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.
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.