| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 0.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $8K | $0 | $8K | 9.12% |
| ADP INC3 Filed as: ADP, INC. | PO BOX 830272 PHILADELPHIA, PA 19182 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.41% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL-ANDERSON AGENCY | PO BOX 1788 GRAND RAPIDS, MI 49501 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $180 | $0 | $180 | 0.22% |
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 | 410 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 410 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 410 | $424K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 410 | $424K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 410 | $424K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 410 | $507K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 410 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.