| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DR STE 200 CAMDEN, NJ 081031000 | UNITEDHEALTHCARE INSURANCE COMPANY | $152K | — | $152K | 2.98% |
| CORPORATE SYNERGIES GROUP LLC3 | 1212 6TH AVE NEW YORK, NY 10036 | FIRST UNUM LIFE INSURANCE COMPANY | $13K | $2K | $14K | 10.22% |
| MCCLELLAN, DAVID J3 Filed as: MCCLELLAN, DAVID, JOEL | 114 ROYAL HORSE WAY REINHOLDS, PA 17569 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $157 | $3K | 2.21% |
| EMPLOYEE FAMILY PROTECTION INC3 | ATTN MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | FIRST UNUM LIFE INSURANCE COMPANY | $246 | — | $246 | 0.17% |
| 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 | $1K | — | $1K | 9.10% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, INC. - | NEW YO PO BOX 654118 DALLAS, TX 75265 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. OF NY | $1K | — | $1K | 7.43% |
| CORPORATE SYNERGIES GROUP LLC3 | 1212 6TH AVE NEW YORK, NY 10036 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 3.02% |
| MCCLELLAN, DAVID J3 Filed as: MCCLELLAN, DAVID, JOEL | 114 ROYAL HORSE WAY REINHOLDS, PA 17569 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $101 | $5 | $106 | 2.69% |
| EMPLOYEE FAMILY PROTECTION INC3 | ATTN MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 1.88% |
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 | 1,080 | 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) | 1,080 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 677 | $5.1M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 677 | $5.1M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. OF NY | 439 | $15K |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 1,080 | $146K |
| Short-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 1,080 | $146K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 1,080 | $142K |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 1,080 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,080 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.