| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV. LLC | 200 SEAPORT BLVD MAIL ZONE V2B BOSTON, MA 02210 | OXFORD HEALTH INSURANCE, INC | $99K | — | $99K | 4.27% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, LLC | 5000 DEARBORN CIRCLE, SUITE 100 MOUNT LAUREL, NJ 08054 | OXFORD HEALTH INSURANCE, INC | — | -$5K | -$5K | -0.22% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV. LLC | 200 SEAPORT BLVD BOSTON, MA 02210 | METROPOLITIAN LIFE INSURANCE CO | $13K | $4K | $18K | 13.40% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE | 200 SEAPORT BLVD MAIL ZONE V2B BOSTON, MA 02210 | CIGNA LIFE INSURANCE CO OF NEW YORK | $3K | — | $3K | 7.55% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE | 200 SEAPORT BLVD MAIL ZONE V2B BOSTON, MA 02210 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $3K | — | $3K | 13.52% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV. LLC | 200 SEAPORT BLVD, MAIL ZONE V2D BOSTON, MA 02210 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE | 200 SEAPORT BLVD MAIL ZONE V2B BOSTON, MA 02210 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $954 | — | $954 | 10.00% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE | 200 SEAPORT BLVD MAIL ZONE V2B BOSTON, MA 02210 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $445 | — | $445 | 11.99% |
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 | 204 | 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) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | OXFORD HEALTH INSURANCE, INC | 275 | $2.3M |
| Dental | METROPOLITIAN LIFE INSURANCE CO | 393 | $132K |
| Life insurance(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO OF NEW YORK | 204 | $51K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 27 | $21K |
| Other(3 contracts) | CIGNA LIFE INSURANCE CO OF NEW YORK | 204 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 393 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.