| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CIGNA3 Filed as: CIGNA VISIONCARE INC. | PO BOX 453099 SUNRISE, FL 333453099 | VISION SERVICE PLAN | — | $3K | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 NONE | Named fiduciary; Participant communication; Other services; Contract Administrator; Direct payment from the plan; Non-monetary compensation; Float revenue; Claims processing Service code 12 | — | $1.3M |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Direct payment from the plan; Plan Administrator Service code 14 | — | $204K |
| SPENCER FANE LLP EIN 44-0561981 NONE | Legal; Direct payment from the plan Service code 29 | — | $144K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 NONE | Contract Administrator; Direct payment from the plan; Participant communication; Claims processing Service code 12 | — | $62K |
| SEGAL CONSULTING EIN 94-1503999 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $50K |
| NEEDLES & ASSOCIATES, LLC EIN 51-0435869 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $46K |
| WELLS FARGO BANK EIN 94-1347393 NONE | Direct payment from the plan; Investment advisory (plan); Participant communication; Participant loan processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Trustee (bank, trust company, or similar financial institution) Service code 15 | — | $37K |
| CORELLIAN SOFTWARE INC. NONE | Direct payment from the plan; Other services Service code 49 | 4440 SW CORBETT AVE., STE 204 PORTLAND, OR 97239 | $16K |
| FRINGE BENEFIT SERVICE, INC. EIN 84-0620086 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $13K |
| EGAN PRINTING NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 1245 ELATI ST DENVER, CO 80204 | $7K |
| CIGNA BEHAVIORAL HEALTH , INC. | Direct payment from the plan; Claims processing; Contract Administrator; Participant communication Service code 12 | — | $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 | 2,441 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 67 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,508 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 67 | $546 |
| Vision | VISION SERVICE PLAN | 2,474 | $0 |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 2,441 | $330K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,474 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.