| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT VENTURES CORP3 Filed as: BENEFIT VENTURES CORPORATION | 1460 ROUTE 9 NORTH SUITE 304 WOODBRIDGE, NJ 07095 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | — | $9K | 6.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC. | PO BOX 730054 DALLAS, TX 75373 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 1.49% |
| BENEFIT VENTURES CORP3 Filed as: BENEFIT VENTURES CORPORATION | 1460 ROUTE 9 NORTH SUITE 304 WOODBRIDGE, NJ 07095 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC. | PO BOX 730054 DALLAS, TX 75373 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $162 | — | $162 | 0.48% |
| BENEFIT VENTURES CORP3 Filed as: BENEFIT VENTURES CORPORATION | 1460 ROUTE 9 NORTH SUITE 304 WOODBRIDGE, NJ 07095 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 9.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC. | PO BOX 730054 DALLAS, TX 75373 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $253 | — | $253 | 0.95% |
| BENEFIT VENTURES CORP3 Filed as: BENEFIT VENTURES CORPORATION | 1460 ROUTE 9 NORTH SUITE 304 WOODBRIDGE, NJ 07095 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $598 | — | $598 | — |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZON INC | PO BOX 730054 DALLAS, TX 75373 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $62 | — | $62 | — |
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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 170 | $128K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 170 | $128K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 170 | $27K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 172 | $34K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 172 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.