| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 | 639 EXECUTIVE PLACE SUITE 202 FAYETTEVILLE, NC 28305 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $30K | — | $30K | 7.29% |
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS | 15305 DALLAS PKWY SUITE 800 ADDISON, TX 75001 | COMPANION LIFE INSURANCE COMPANY | $16K | — | $16K | 10.07% |
| THE CASON GROUP INC3 Filed as: THE CASON GROUP | 1612 MARION ST COLUMBIA, SC 29201 | COMPANION LIFE INSURANCE COMPANY | $5K | — | $5K | 3.27% |
| EBENCONCEPTS COMPANY3 | 639 EXECUTIVE PLACE SUITE 202 FAYETTEVILLE, NC 28305 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 14.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMINISTRATOR | Other fees; Contract Administrator; Claims processing Service code 12 | — | $5K |
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 | 99 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 99 | $429K |
| Dental | COMPANION LIFE INSURANCE COMPANY | 84 | $155K |
| Vision | COMPANION LIFE INSURANCE COMPANY | 84 | $155K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 84 | $155K |
| Short-term disability | COMPANION LIFE INSURANCE COMPANY | 84 | $155K |
| Other | COMPANION LIFE INSURANCE COMPANY | 84 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 99 | — |
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.