| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 8144 WALNUT HILL LANE 16TH FLOOR DALLAS, TX 75231 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $61K | $0 | $61K | 9.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 2711 N. HASKELL AVE STE. 2000 DALLAS, TX 77024 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.30% |
| KEVIN M PAILET3 Filed as: KEVIN M. PAILET | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC. | 2711 N. HASKELL AVE STE. 2000 DALLAS, TX 77024 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $17K | $0 | $17K | 21.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 ADMINISTRATOR | Contract Administrator Service code 13 | — | $29K |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $624K |
| Dental | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 230 | $86K |
| Vision | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 230 | $86K |
| Life insurance | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 128 | $82K |
| Short-term disability | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 128 | $82K |
| Long-term disability | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 128 | $82K |
| Other | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 128 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.