| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 333 WEST 34TH STREET NEW YORK, NY 10001 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $96 | — | $96 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 58-1640157 NONE | Contract Administrator Service code 13 | P.O. BOX 20643 LEHIGH VALLEY, PA 18002 | $424K |
| SEGAL COMPANY EIN 13-2619259 NONE | Consulting (pension) Service code 17 | — | $104K |
| EMPLOYEE A EIN 86-0572343 EMPLOYEE | Employee (plan) Service code 30 | — | $71K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 NONE | Accounting (including auditing) Service code 10 | — | $32K |
| DYNAMARC EIN 20-3555695 NONE | Other services Service code 49 | — | $11K |
| BLAKE & UHLIG EIN 48-0918231 NONE | Legal Service code 29 | — | $10K |
| US TREASURY NONE | Other fees Service code 99 | 799 9TH STREET NW WASHINGTON, DC 20001 | $7K |
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 | 1,334 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 696 | $235K |
| Vision | VISION SERVICE PLAN | 654 | $55K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,260 | $606K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,036 | $765K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,399 | $643K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,399 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.