| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CIGNA3 Filed as: CIGNA VISIONCARE INC. | — | VISION SERVICE PLAN | — | $4K | $4K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 NONE | Non-monetary compensation; Contract Administrator; Named fiduciary; Other services; Direct payment from the plan; Claims processing; Float revenue; Participant communication Service code 12 | — | $1.6M |
| WELFARE & PENSION ADMIN SVCS INC. NONE | Direct payment from the plan; Plan Administrator Service code 14 | 7525 SE 24TH ST., STE 200 MERCER ISLAND, WA 98040 | $377K |
| SPENCER FANE LLP EIN 44-0561981 NONE | Legal; Direct payment from the plan Service code 29 | — | $117K |
| SEGAL CONSULTING EIN 94-1503999 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $75K |
| CIGNA BEHAVIORAL HEALTH, INC EIN 41-1648670 NONE | Direct payment from the plan; Participant communication; Contract Administrator; Claims processing Service code 12 | — | $70K |
| WELLS FARGO BANK EIN 94-1347393 NONE | Trustee (bank, trust company, or similar financial institution); Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant loan processing; Direct payment from the plan; Investment advisory (plan); Participant communication Service code 15 | — | $41K |
| NEEDLES & ASSOCIATES, LLC EIN 51-0435869 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $34K |
| CORELLIAN SOFTWARE INC NONE | Direct payment from the plan; Other services Service code 49 | 4440 SW CORBETT AVE STE 204 PORTLAND, OR 97239 | $15K |
| INNOVEST EIN 84-1612955 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $15K |
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 | 2,467 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 59 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,526 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 28 | $243 |
| Vision | VISION SERVICE PLAN | 2,376 | $0 |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 2,477 | $535K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,477 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.