| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHCARE BENEFITS INC3 | 1501 REEDSDALE STREET STE 403 PITTSBURGH, PA 15233 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.61% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.32% |
| 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 | 600 W LOVELAND AVE STE 5A LOVELAND, OH 45140 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1501 REEDSDALE STREET SUITE 403 PITTSBURGH, PA 15233 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $32 | $74 | $106 | 9.87% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1501 REEDSDALE STREET SUITE 403 PITTSBURGH, PA 15233 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $8 | $5 | $13 | 4.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 SERVICES PURSUANT TO ASA | Contract Administrator; Other services; Direct payment from the plan; Participant communication; Float revenue; Non-monetary compensation; Claims processing; Named fiduciary Service code 12 | — | $754K |
| CIGNA BEHAVIORAL HEALTH, INC EIN 41-1648670 CONTRACTED FOR EAP | Direct payment from the plan; Contract Administrator; Claims processing; Participant communication Service code 12 | — | $23K |
| CIGNA | Non-monetary compensation; Direct payment from the plan; Named fiduciary; Float revenue; Participant communication; Claims processing; Contract Administrator; Other services 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 | 977 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 52 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,029 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILATES | 2,018 | $729K |
| Vision | VISION SERVICE PLAN | 609 | $130K |
| Life insurance | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 185 | $39K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4 | $1K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILATES | 2,018 | $729K |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILATES | 2,018 | $768K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,018 | — |
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.