| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEGAL BENEFITS STOLTZ LLC4 Filed as: LEGAL BENEFITS - STOLTZ LLC | SUITE 115 426 N 44TH ST PHOENIX, AZ 85008 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $16K | — | $16K | 16.60% |
| RHONA S UNSELL INC4 | STE 370-152 6525 GUNPARK DRIVE BOULDER, CO 80301 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $14 | — | $14 | 0.01% |
| PATRICE L PARISEAU4 | 4026 XENIA AVE N MINNEAPOLIS, MN 55422 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $9 | — | $9 | 0.01% |
| ALAN ROMAN4 | 24 ARUNDEL PL SAINT LOUIS, MO 63105 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $3 | — | $3 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN | PO BOX 29018 PORTLAND, OR 972969018 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $699 | — | $699 | 8.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX 741909 PO BOX 741909 ATLANTA, GA 30374 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $761 | — | $761 | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX 741909 PO BOX 741090 ATLANTA, GA 30374 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $337 | — | $337 | 9.99% |
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 | 3,384 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,404 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $16K |
| Dental(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,456 | $291K |
| Vision | VISION SERVICE PLAN | 3,149 | $220K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 9,039 | $1.9M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 9,039 | $1.9M |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 9,039 | $1.9M |
| Other(5 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,456 | $397K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,039 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.