| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN DBA ASSURANCE | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $13K | $0 | $13K | 9.89% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 10.00% |
| BENEFIT HARBOR INSURANCE SERVICES3 Filed as: BENEFIT HARBOR INSURANCE SVCS LLC | 5445 LEGACY DRIVE, SUITE 250 PLANO, TX 75024 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $530 | $530 | 1.59% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: THE NIA GROUP, MARSH & MCLENNAN | 161 WASHINGTON STREET, STE 1200 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $423 | $423 | 1.27% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 10.00% |
| BENEFIT HARBOR INSURANCE SERVICES3 Filed as: BENEFIT HARBOR INSURANCE SVCS LLC | 5445 LEGACY DRIVE, SUITE 250 PLANO, TX 75024 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $509 | $509 | 1.62% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: THE NIA GROUP, MARSH & MCLENNAN | 161 WASHINGTON STREET, STE 1200 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $281 | $281 | 0.89% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 10.00% |
| BENEFIT HARBOR INSURANCE SERVICES3 Filed as: BENEFIT HARBOR INSURANCE SVCS LLC | 5445 LEGACY DRIVE, SUITE 250 PLANO, TX 75024 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $509 | $509 | 1.62% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: THE NIA GROUP, MARSH & MCLENNAN | 161 WASHINGTON STREET, STE 1200 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $276 | $276 | 0.88% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN DBA ASSURANCE | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 21.71% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN DBA ASSURANCE | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $0 | $2K | 23.63% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $544 | $0 | $544 | 9.99% |
| BENEFIT HARBOR INSURANCE SERVICES3 Filed as: BENEFIT HARBOR INSURANCE SVCS LLC | 5445 LEGACY DRIVE, SUITE 250 PLANO, TX 75024 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $86 | $86 | 1.58% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: THE NIA GROUP, MARSH & MCLENNAN | 161 WASHINGTON STREET, STE 1200 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $57 | $57 | 1.05% |
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 | 298 | 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) | 298 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 160 | $129K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 160 | $129K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 387 | $33K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 387 | $31K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 387 | $31K |
| Other(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 387 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 387 | — |
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.