| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES, INC. | 141 W GREEN STREET PASADENA, CA 91105 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 0.55% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES, INC. | 141 W GREEN STREET PASADENA, CA 91105 | SUN LIFE ASSURANCE COMPANY OF CANADA | $17K | $0 | $17K | 13.75% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES, INC. | 141 W GREEN STREET PASADENA, CA 91105 | VISION SERVICE PLAN | $284 | $0 | $284 | 1.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $57K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $23K |
| DISCOVERY BENEFITS EIN 83-4136902 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $4K |
| CIGNA | Other services Service code 49 | — | $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 | 218 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 220 | $23K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 226 | $124K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 226 | $124K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 226 | $124K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 288 | $468K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 226 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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.