| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NY 07981 | CIGNA HEALTH AND LIFE INSURANCE | — | $79K | $79K | 2.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | — | BLUE CROSS BLUE SHIELD OF ILLINOIS | $48K | $2K | $50K | 4.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $4K | $4K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | GBS DIVISION 200 JEFFERSON PARK WHIPPANY, NJ 07981 | FIRST UNUM LIFE INSURANCE COMPANY | $687 | — | $687 | 2.62% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS LLC | STE 205 700 KINDERKAMACK ROAD ORADELL, NJ 07675 | FIRST UNUM LIFE INSURANCE COMPANY | $687 | — | $687 | 2.62% |
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 | 231 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE | 334 | $4.9M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE | 334 | $3.7M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE | 334 | $3.6M |
| Life insurance(2 contracts, 2 carriers) | STANDARD OF NEW YORK | 254 | $203K |
| Long-term disability | STANDARD OF NEW YORK | 236 | $102K |
| Other | FEDERAL INSURANCE COMPANY | 302 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 334 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.