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| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 SERVICE PROVIDER | Claims processing; Named fiduciary; Float revenue; Contract Administrator; Other services; Direct payment from the plan; Non-monetary compensation; Participant communication Service code 12 | — | $7K |
| CIGNA | Float revenue; Participant communication; Claims processing; Contract Administrator; Named fiduciary; Non-monetary compensation; Other services; Direct payment from the plan 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 | 110 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 73 | $295K |
| Dental | ACE AMERICAN INSURANCE COMPANY | 81 | $87K |
| Vision | ACE AMERICAN INSURANCE COMPANY | 81 | $87K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $4K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 4 | $2K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 110 | — |
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.