| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACOBON GOLDFARB & SCOTT INC3 | 101 CROWFORDS CORNER RD HOLMDEL, NJ 07733 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $13K | — | $13K | 4.12% |
| JACOB SILVERMAN3 | 1061 THOMAS KNAPP PKWY FORT MILL, SC 29715 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $1K | — | $1K | 0.43% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL SERVI | 1133 WEST CHESTER AVE. WHITE PLAINS, NY 10604 | CIGNA | $10K | — | $10K | 4.25% |
| JACOB GOLDFARB & SIN INC3 | 101 CRAWFORD CORNER RD STE 1300 HOLMDEL, NJ 07733 | DELTA DENTAL OF NJ, INC. | $4K | — | $4K | 4.12% |
| JAD BENEFITS GROUP3 | 112 COLLEEN COURT NE LEESBURG, VA 20176 | DELTA DENTAL OF NJ, INC. | $33 | — | $33 | 0.03% |
| JACOB SILVERMAN3 Filed as: JACOB SILVERMAN-BOR | 112 COLLEEN CT LEESBURG, VA 20176 | EYEMED | $717 | — | $717 | 4.24% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL SERVI | 1133 WEST CHESTER AVE. WHITE PLAINS, NY 10604 | EYEMED | — | $620 | $620 | 3.67% |
| JGS INSURANCE3 | 101 CRAWFORDS CORNER RD, STE 1300 HOLMDEL, NJ 07733 | EYEMED | $524 | — | $524 | 3.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 | Participant communication; Direct payment from the plan; Non-monetary compensation; Claims processing; Contract Administrator; Other services; Float revenue; Named fiduciary Service code 12 | — | $20K |
| CENTERSTONE INSURANCE AND FINANCIAL EIN 95-4018229 | Insurance agents and brokers Service code 22 | 1133 WESTCHESTER AVE WHITE PLAINS, NY 10604 | $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 | 266 | 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) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 162 | $554K |
| Dental | DELTA DENTAL OF NJ, INC. | 266 | $108K |
| Vision | EYEMED | 241 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.