| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 3209 SOUTH CHEROKEE LANE SUITE 510 WOODSTOCK, GA 30188 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $79K | $125K | $204K | 27.52% |
| MARSH & MCLENNAN AGENCY LLC3 | 3209 SOUTH CHEROKEE LANE SUITE 510 WOODSTOCK, GA 30188 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $12K | $220 | $13K | 10.10% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: J. SMITH LANIER & CO | PO BOX 70 WEST POINT, GA 31833 | EYE MED VISION ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.70% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARCH & MCLENNAN AGENCY LLC | 3209 SOUTH CHEROKEE LANE SUITE 510 WOODSTOCK, GA 30188 | CIGNA DENTAL HEALTH OF FLORIDA INC | $2K | — | $2K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $3 | $2K | 15.02% |
| MARSH & MCLENNAN AGENCY LLC3 | 3209 SOUTH CHEROKEE LANE SUITE 510 WOODSTOCK, GA 30188 | CIGNA DENTAL HEALTH OF TEXAS INC | $725 | — | $725 | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 3209 SOUTH CHEROKEE LANE SUITE 510 WOODSTOCK, GA 30188 | CIGNA DENTAL HEALTH OF MISSOURI INC | $116 | — | $116 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERICAN SPECIALTY HEALTH EIN 33-0571188 | Contract Administrator; Other services; Direct payment from the plan; Claims processing; Non-monetary compensation; Named fiduciary; Float revenue; Participant communication Service code 12 | 10221 WATERIDGE CIR 201 SAN DIEGO, CA 92121 | $0 |
| AMPLIFON HEARING HEALTHCARE EIN 85-0437037 | Participant communication; Contract Administrator; Other services; Claims processing; Named fiduciary; Float revenue; Direct payment from the plan; Non-monetary compensation Service code 12 | FIFTH STREET TOWERS 150 SOUTH 5TH STREET SUITE 2300 MINNEAPOLIS, MN 55402 | $0 |
| FIT FOR LIFE EIN 38-3983812 | Participant communication; Contract Administrator; Non-monetary compensation; Claims processing; Named fiduciary; Float revenue; Other services; Direct payment from the plan Service code 12 | 833 W SOUTH BOULDER RD LOUISVILLE, CO 80027 | $0 |
| OMADA HEALTH, INC EIN 45-2355015 | Contract Administrator; Other services; Direct payment from the plan; Claims processing; Non-monetary compensation; Named fiduciary; Float revenue; Participant communication Service code 12 | 500 SANSOME ST SUITE 200 SAN FRANCISCO, CA 94111 | $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 | 318 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 318 | $740K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 201 | $126K |
| Vision | EYE MED VISION ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPANY | 323 | $24K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 283 | $52K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 235 | $28K |
| Other(5 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 233 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 323 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.