| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $15K | $0 | $15K | 6.99% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $3K | $0 | $3K | 13.76% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 9.58% |
| PACIFIC ADVISORS LLC3 | 333 INDIAN HILL BLVD CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $25 | $0 | $25 | 0.19% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | VISION SERVICE PLAN | $517 | $0 | $517 | 8.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 N/A | Other services; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan; Named fiduciary; Contract Administrator; Float revenue Service code 12 | — | $7K |
| CIGNA HEALTH AND LIFE INSURANCE COM | Named fiduciary; Direct payment from the plan; Contract Administrator; Non-monetary compensation; Claims processing; Float revenue; Other services; 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 | 30 | 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) | 30 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 12 | $222K |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 30 | $23K |
| Vision | VISION SERVICE PLAN | 15 | $6K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 29 | $13K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 29 | $13K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 29 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 30 | — |
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.