| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 141 WEST JACKSON BOULEVARD SUITE 1000 CHICAGO, IL 60604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $46K | $0 | $46K | 16.56% |
| SEQUOIA BENEFITS & INS SVCS LLC1 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$61 | $2K | $2K | 0.69% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN. SVCS | UNKNOWN SOUTH JORDAN, UT 84095 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | -$24 | -$24 | -0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 141 WEST JACKSON BOULEVARD SUITE 1000 CHICAGO, IL 60604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $8K | $0 | $8K | 9.94% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | -$8 | $438 | $430 | 0.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 141 WEST JACKSON BOULEVARD SUITE 1000 CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 6.92% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BEN. AND INS. SERVICES, LLC | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 3.08% |
| BENEFITMALL3 | 2100 GENG ROAD, SUITE 210 OFFICE 230 PALO ALTO, CA 94303 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$58 | $606 | $548 | 1.39% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$23 | $242 | $219 | 0.56% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 182 | $277K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 122 | $77K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 122 | $77K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 124 | $39K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 124 | $39K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 182 | $277K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 124 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.