| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT E. MUZIKOWSKI3 Filed as: ROBERT E MUZIKOWSKI | 1N WACKER DR. STE. 4600 CHICAGO, IL 60606 | CIGNA | $62K | — | $62K | 3.03% |
| KABS AGENCY, INC.3 Filed as: KABS AGENCY INC. | 77 GRASSLANDS CIRCLE MOUNT SINAI, NY 11766 | CIGNA | $62K | — | $62K | 3.03% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD. STE. 200 HAUPPAUGE, NY 11788 | CIGNA | — | $58K | $58K | 2.85% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD STE. 200 HAUPPAUGE, NY 11788 | CIGNA | — | $13K | $13K | 4.97% |
| ROBERT E. MUZIKOWSKI3 | 1N WACKER DR. STE. 4600 CHICAGO, IL 60606 | CIGNA | $9K | — | $9K | 3.48% |
| KABS AGENCY, INC.3 | 77 GRASSLANDS CIRCLE MOUNT SINAI, NY 11766 | CIGNA | $9K | — | $9K | 3.48% |
| KABS AGENCY, INC.3 Filed as: KABS AGENCY INC. | 77 GRASSLANDS CIRCLE MOUNT SINAI, NY 11766 | NEW YORK LIFE | $3K | — | $3K | 6.26% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD. STE. 200 HAUPPAUGE, NY 11788 | NEW YORK LIFE | $1K | $1K | $2K | 5.08% |
| ROBERT E. MUZIKOWSKI3 Filed as: ROBERT MUZIKOWSKI | 1N WACKER DRIVE SUITE 4600 CHICAGO, IL 60606 | NEW YORK LIFE | $201 | — | $201 | 0.42% |
| KABS AGENCY, INC.3 Filed as: KABS AGENCY INC. | 77 GRASSLANDS CIRCLE MOUNT SINAI, NY 11766 | NEW YORK LIFE | $4K | — | $4K | 8.86% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD. STE. 200 HAUPPAUGE, NY 11788 | NEW YORK LIFE | $1K | $1K | $2K | 5.08% |
| ROBERT E. MUZIKOWSKI3 Filed as: ROBERT MUZIKOWSKI | 1N WACKER DRIVE CHICAGO, IL 60606 | NEW YORK LIFE | $185 | — | $185 | 0.44% |
| ROBERT E. MUZIKOWSKI3 | 1N WACKER DR. STE. 4600 CHICAGO, IL 60606 | VISION SERVICE PLAN | $441 | — | $441 | 2.96% |
| KABS AGENCY, INC.3 | 77 GRASSLANDS CIR. MOUNT SINAI, NY 11766 | VISION SERVICE PLAN | $441 | — | $441 | 2.96% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD. STE. 2 HAUPPAUGE, NY 11788 | VISION SERVICE PLAN | $397 | — | $397 | 2.66% |
| KABS AGENCY, INC.3 Filed as: KABS AGENCY INC. | 77 GRASSLANDS CIRCLE MOUNT SINAI, NY 11766 | NEW YORK LIFE | $1K | — | $1K | 9.74% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD. STE. 200 HAUPPAUGE, NY 11788 | NEW YORK LIFE | $304 | $317 | $621 | 5.08% |
| ROBERT E. MUZIKOWSKI3 Filed as: ROBERT MUZIKOWSKI | 1N WACKER DRIVE SUITE 4600 CHICAGO, IL 60606 | NEW YORK LIFE | $94 | — | $94 | 0.77% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSING | Claims processing; Direct payment from the plan Service code 12 | — | $375K |
| CIGNA HEALTH & LIFE INSURANCE COMPA | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator 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 | 260 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 260 | $2.0M |
| Dental | CIGNA | 164 | $262K |
| Vision | VISION SERVICE PLAN | 100 | $15K |
| Life insurance | NEW YORK LIFE | 0 | $48K |
| Long-term disability | NEW YORK LIFE | 0 | $42K |
| Other | NEW YORK LIFE | 0 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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.