| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | P.O. BOX 1237 GLASTONBURY, CT 06033 | FIRST UNUM LIFE INSURANCE COMPANY | $71K | $4K | $75K | 6.72% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35, STE 368 WALL, NJ 07719 | FIRST UNUM LIFE INSURANCE COMPANY | $18K | $0 | $18K | 6.41% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | P.O. BOX 1237 GLASTONBURY, CT 06033 | FIRST UNUM LIFE INSURANCE COMPANY | $10K | $7K | $17K | 6.03% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | P.O. BOX 1237 GLASTONBURY, CT 06033 | FIRST UNUM LIFE INSURANCE COMPANY | $6K | $788 | $7K | 17.05% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35, STE 368 WALL, NJ 07719 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $0 | $2K | 5.01% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | P.O. BOX 1237 GLASTONBURY, CT 06033 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | $708 | $6K | 17.35% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35, STE 368 WALL, NJ 07719 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $0 | $2K | 5.12% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | P.O. BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $168 | $0 | $168 | 4.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 INSURANCE BROKERAGE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $1.1M |
| INGENIORX, INC. EIN 82-3062245 | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $0 |
| ZITOFSKY, NORMAN EIN 23-7391136 INSURANCE BROKERAGE | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $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 | 1,506 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,506 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 1,506 | $790K |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 1,506 | $790K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 1,506 | $790K |
| Life insurance(3 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 1,588 | $1.4M |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 3 | $4K |
| Long-term disability(3 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 1,209 | $347K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 1,506 | $790K |
| Other(5 contracts, 3 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 1,588 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,588 | — |
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.