| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CREST INSURANCE GROUP LLC3 Filed as: CREST INSURANCE GROUP, LLC | 5285 E WILLIAMS CIR SUITE 4500 TUCSON, AZ 85711 | CIGNA LIFE AND HEALTH INSURANCE COMPANY | $38K | $0 | $38K | 21.63% |
| ROGERS BENEFIT GROUP INC3 | 5110 N. 40TH ST. STE 234 PHOENIX, AZ 85018 | CIGNA LIFE AND HEALTH INSURANCE COMPANY | $0 | $15K | $15K | 8.41% |
| CREST INSURANCE GROUP LLC3 | 5285 E WILLIAMS CIR STE 4500 TUCSON, AZ 85711 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $0 | $19K | 22.47% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $5K | $7K | 7.91% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 6.17% |
| CREST INSURANCE GROUP LLC3 Filed as: CREST INSURANCE GROUP | 5285 E WILLIAMS CIRCLE STE 4500 TUCSON, AZ 85711 | NEW BENEFITS | $771 | $0 | $771 | 12.37% |
| CREST INSURANCE GROUP LLC3 Filed as: CREST INSURANCE GROUP, LLC | 5285 E WILLIAMS CIR SUITE 4500 TUCSON, AZ 85711 | CIGNA DENTAL HEALTH PLAN OF ARIZONA, INC. | $327 | $0 | $327 | 15.01% |
| ROGERS BENEFIT GROUP INC3 | 5110 N. 40TH ST. STE 234 PHOENIX, AZ 85018 | CIGNA DENTAL HEALTH PLAN OF ARIZONA, INC. | $0 | $109 | $109 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INS COMPANY EIN 59-1031071 NONE | Other services; Non-monetary compensation; Float revenue; Participant communication; Direct payment from the plan; Named fiduciary; Claims processing; Contract Administrator Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $34K |
| CIGNA | Named fiduciary; Float revenue; Direct payment from the plan; Other services; Participant communication; Contract Administrator; Claims processing; Non-monetary compensation 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 | 101 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA LIFE AND HEALTH INSURANCE COMPANY | 101 | $177K |
| Dental(2 contracts, 2 carriers) | CIGNA LIFE AND HEALTH INSURANCE COMPANY | 101 | $180K |
| Vision | CIGNA LIFE AND HEALTH INSURANCE COMPANY | 101 | $177K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 93 | $84K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 93 | $84K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 93 | $84K |
| Prescription drug | CIGNA LIFE AND HEALTH INSURANCE COMPANY | 101 | $177K |
| Stop-loss / reinsurancereinsurance | CIGNA LIFE AND HEALTH INSURANCE COMPANY | 101 | $177K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 93 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 101 | — |
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.