| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DRIVE, SUITE 200 CAMDEN, NJ 08103 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 4.97% |
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DRIVE SUITE 200 CAMDEN, NJ 08103 | SHELTERPOINT LIFE INSURANCE COMPANY | $3K | — | $3K | 6.96% |
| THE DBL CENTER LTD3 Filed as: DBL CENTER LTD | 155 PINELAWN ROAD SUITE 120S MELVILLE, NY 11747 | SHELTERPOINT LIFE INSURANCE COMPANY | $3K | — | $3K | 6.96% |
| LORENA GILER LOPEZ3 | 7784 271ST ST NEW HYDE PARK, NY 11040 | AFLAC | $2K | $85 | $2K | 7.16% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY A LIBECCI | 4864 ARTHUR KILL RD STE 3 STATEN ISLAND, NY 10309 | AFLAC | $1K | $112 | $1K | 6.00% |
| ANDREW SHULMAN3 | 138 E 78TH ST APT 3B NEW YORK, NY 10075 | AFLAC | $975 | — | $975 | 4.35% |
| KRISTEN PARZIANO3 | 15 10TH ST STATEN ISLAND, NY 10306 | AFLAC | $753 | $214 | $967 | 4.32% |
| PATRICK RUHLE3 Filed as: PATRICK C HARDIE | 14 WALL ST STE 8C NEW YORK, NY 10005 | AFLAC | $617 | $82 | $699 | 3.12% |
| MJ INSURANCE3 Filed as: ANTHONY CAVALLARO & VARIOUS AGENTS | 1 BAY CLUB DR APT 4A BAYSIDE, NY 11360 | AFLAC | $447 | — | $447 | 2.00% |
| CHRISTOPHER YOST3 | 2751 CRESCENT ST APT 2A ASTORIA, NY 11102 | AFLAC | $201 | $82 | $283 | 1.26% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, INC. | NEW YORK, NY PO BOX 654118 DALLAS, TX 75265 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. OF NY | $192 | — | $192 | 4.13% |
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 | 187 | 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) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 99 | $74K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. OF NY | 79 | $5K |
| Life insurance | CIGNA LIFE INSURANCE CO. OF NEW YORK | 146 | $13K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 146 | $13K |
| Other(3 contracts, 3 carriers) | SHELTERPOINT LIFE INSURANCE COMPANY | 186 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.