| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 4.67% |
| GCG FINANCIAL LLC3 Filed as: DAVID STEPHEN DICKERSON | 6001 COCHRAN RD STE 400 SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| MCKELVEY, PHILIP, NEILL3 Filed as: MCKELVEY, PHILIP, N | 3931 S DIXIE DR DAYTON, OH 45439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| SAGEWELL PARTNERS INC3 | 1501 REEDSDALE STREET SUITE 3005 PITTSBURGH, PA 15233 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
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 | 613 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 42 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 655 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $12K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILATES | 1,313 | $575K |
| Vision | VISION SERVICE PLAN | 468 | $95K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILATES | 1,313 | $575K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILATES | 1,313 | $575K |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILATES | 1,313 | $615K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,313 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.