| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOITS INSURANCE SERVICE INC3 | 160 W SANTA CLARA STREET #575 SAN JOSE, CA 95113 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | $0 | $35K | 5.32% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA | 160 W SANTA CLARA, #575 SAN JOSE, CA 95113 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $7K | $20K | 13.39% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP PROPERTY & CASUALTY | 160 W SANTA CLARA STREET #575 SAN JOSE, CA 95113 | NATIONAL UNION FIRE INSURANCE | $150 | $0 | $150 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 SERVICE PROVIDER | Contract Administrator Service code 13 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $100K |
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 | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 98 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 147 | $149K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 147 | $149K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 147 | $149K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 147 | $149K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 28 | $459K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 98 | $655K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 147 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.