| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE, STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.06% |
| HARVARD PRINTING GROUP5 | 175 US HIGHWAY 46 WEST FAIRFIELD, NJ 07004 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $95 | $95 | 0.00% |
| LEGAL BENEFITS STOLTZ LLC4 Filed as: LEGAL BENEFITS - STOLTZ, LLC | 14617 N. 45TH PL PHOENIX, AZ 85032 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $21K | — | $21K | 21.00% |
| MARLA BRYAN4 | 910 E. LAKE ST BROWNFIELD, TX 79316 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $25 | — | $25 | 0.03% |
| RHONA S UNSELL INC4 Filed as: RHONA S. UNSELL INC. | 6525 GUNPARK DR., STE 370-152 BOULDER, CO 80301 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $18 | — | $18 | 0.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN | PO BOX 29018 PORTLAND, OR 97296 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $559 | — | $559 | 2.46% |
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 | 3,554 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 39 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,593 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $23K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,225 | $248K |
| Vision | VISION SERVICE PLAN | 3,281 | $291K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,554 | $2.0M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,554 | $2.0M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,554 | $2.0M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,554 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,554 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.