| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA MADISON PARTNERS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | AETNA LIFE INSURANCE COMPANY | $2K | — | $2K | 0.05% |
| PREMIER BENEFIT PLANS INC3 Filed as: PREMIER BENEFIT PLANS | 35 PINELAWN ROAD MELVILLE, NY 11747 | AETNA LIFE INSURANCE COMPANY | $381 | — | $381 | 0.01% |
| PREMIER BENEFIT PLANS INC3 | 35 PINELAWN ROAD MELVILLE, NY 11747 | EQUITABLE FINANCIAL LIFE INSURANCE CO. OF AMERICA | $3K | — | $3K | 5.28% |
| PREMIER BENEFIT PLANS INC3 | 35 PINELAWN RD STE 208E MELVILLE, NY 11747 | MUTUAL OF OMAHA | $4K | — | $4K | 15.00% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | HARTFORD LIFE AND ACCIDENT | $493 | — | $493 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACRISURE, LLC DBA MADISON PARTNERS INSURANCE BROKER | Insurance brokerage commissions and fees Service code 53 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | $130K |
| MOHAMED ARBAB EIN 13-1966980 EMPLOYEE | Employee (plan) Service code 30 | 889 BROADWAY BAYONNE, NJ 07002 | $77K |
| FUIMAN MOGILA LLP EIN 93-1652658 CO-COUNSEL | Legal Service code 29 | 153 CENTRAL AVENUE PO BOX 3003 WESTFILED, NJ 07091 | $59K |
| THE LAMBOS FIRM, LLP EIN 13-3864093 CO-COUNSEL | Legal Service code 29 | 300 SOUTH BROADWAY SUITE 410 TARRYTOWN, NY 10591 | $59K |
| RICHARD ROSSIELLO EIN 13-1966980 EMPLOYEE | Employee (plan) Service code 30 | 889 BROADWAY BAYONNE, NJ 07002 | $42K |
| DESENA & COMPANY CPAS EIN 20-0609534 AUDITOR | Accounting (including auditing) Service code 10 | 100 EAGLE ROCK AVENUE SUITE 100 EAST HANOVER, NJ 07936 | $27K |
| PREMIER BENEFIT PLANS INSURANCE BROKER | Insurance brokerage commissions and fees Service code 53 | 35 PINELAWN ROAD MELVILLE, NY 11747 | $26K |
| CYNOMYS, INC. EIN 82-2668930 ACTUARY | Actuarial Service code 11 | 16170 POPPY SEED CIRCLE DELRAY BEACH, FL 33484 | $12K |
| KATHY SCHIERECK EIN 13-1966980 ACCOUNTANT | Accounting (including auditing) Service code 10 | 889 BROADWAY BAYONNE, NJ 07002 | $11K |
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 | 181 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 88 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 370 | $4.4M |
| Dental | EQUITABLE FINANCIAL LIFE INSURANCE CO. OF AMERICA | 80 | $52K |
| Vision | AETNA LIFE INSURANCE COMPANY | 370 | $4.4M |
| Life insurance(2 contracts, 2 carriers) | MUTUAL OF OMAHA | 169 | $25K |
| Other(2 contracts, 2 carriers) | MUTUAL OF OMAHA | 169 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.