| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV. LLC | 200 SEAPORT BLVD, MAIL ZONE V2B BOSTON, MA 02210 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $78K | — | $78K | 8.32% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV. LLC | 200 SEAPORT BLVD MAIL ZONE V2B BOSTON, MA 02210 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $22K | — | $22K | 9.92% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV. LLC | 200 SEAPORT BLVD BOSTON, MA 02211 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 11.30% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV. LLC | 200 SEAPORT BLVD BOSTON, MA 02210 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 19.12% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV, LLC | 200 SEAPORT BLVD BOSTON, MA 02210 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 14.42% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE | 200 SEAPORT BLVD BOSTON, MA 02210 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV. LLC | 200 SEAPORT BLVD BOSTON, MA 02210 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 17.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 CONTRACT ADMIN FEES | Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services Service code 12 | — | $29K |
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 | 198 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 280 | $933K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 217 | $223K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 217 | $223K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 260 | $40K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 260 | $27K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 260 | $29K |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 260 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.