| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 744831 ATLANTA, GA 30374 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $15K | — | $15K | 1.53% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR STE 100 JOHNS CREEK, GA 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | — | $14K | 26.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 11330 LAKEFIELD DR STE 100 JOHNS CREEK, GA 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR. SUITE 100 JOHNS CREEK, GA 30097 | EYE MED VISION ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 9.27% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR STE 100 JOHNS CREEK, GA 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR STE 100 JOHNS CREEK, GA 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR STE 100 JOHNS CRREK, GA 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 744831 ATLANTA, GA 30374 | CIGNA DENTAL HEALTH OF FLORIDA INC | $493 | — | $493 | 9.19% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 744831 ATLANTA, GA 30374 | CIGNA DENTAL HEALTH OF TEXAS INC | $419 | — | $419 | 8.86% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 744831 ATLANTA, GA 30374 | CIGNA DENTAL HEALTH PLAN OF ARIZONA, INC | $244 | — | $244 | 8.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 MEDICAL FEES | Float revenue; Direct payment from the plan; Contract Administrator; Non-monetary compensation; Other services; Named fiduciary; Participant communication; Claims processing Service code 12 | — | $253K |
| MARSH & MCLENNAN AGENCY BROKER | Other commissions Service code 55 | PO BOX 744831 ATLANTA, GA 30374 | $92K |
| CIGNA | Float revenue; Direct payment from the plan; Claims processing; Other services; Named fiduciary; Participant communication; Contract Administrator; Non-monetary compensation Service code 12 | — | $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 | 253 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 477 | $1.0M |
| Vision | EYE MED VISION ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPANY | 411 | $35K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 293 | $79K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 293 | $51K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 293 | $43K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 253 | $837K |
| Other(5 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 477 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 477 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.