| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $87K | $87K | 2.11% |
| BOLLINGER INC3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $578 | $578 | 0.01% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS LLC | STE 205 700 KINDERKAMACK ROAD ORADELL, NJ 07675 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $49 | $3K | 9.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 9.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | — | $92 | $92 | 0.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $1K | $1K | 5.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT INSURANCE SERVICE | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $1K | $1K | 4.17% |
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 | 218 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 352 | $5.6M |
| Dental(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 352 | $5.5M |
| Vision(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 352 | $5.5M |
| Life insurance(2 contracts, 2 carriers) | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | 252 | $189K |
| Long-term disability | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | 221 | $91K |
| Other | FEDERAL INSURANCE COMPANY | 276 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 352 | — |
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.