| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: BWD AGENCY INC | 45 EXECUTIVE DRIVE PLAINVIEW, NY 11803 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 3.94% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 1250 CAPITAL OF TX HWY S BLDG II ST AUSTIN, TX 78746 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $1K | $1K | 1.07% |
| DAVID KUSHNER3 | 16831 C ISLE OF PALMS DRIVE DELRAY BEACH, FL 33484 | SHELTERPOINT LIFE INSURANCE CO | $9K | — | $9K | 6.36% |
| THE DBL CENTER LTD3 Filed as: DBL CENTER LTD | 155 PINELAWN ROAD SUITE 120S MELVILLE, NY 11747 | SHELTERPOINT LIFE INSURANCE CO | — | — | $0 | 0.00% |
| ASSUREDPARTNERS3 Filed as: BWD AGENCY INC | 45 EXECUTIVE DRIVE PLAINVIEW, NY 11803 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 2.84% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 1250 CAPITAL OF TX HWY S BLDG II ST AUSTIN, TX 78746 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $1K | $1K | 1.05% |
| ASSUREDPARTNERS4 Filed as: BWD AGENCY INC | 45 EXECUTIVE DRIVE PLAINVIEW, NY 11803 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $15K | $38 | $15K | 15.04% |
| NFP INSURANCE SERVICES INC4 Filed as: NFP INSURANCE SERVICES INC. | 1250 CAPITAL OF TX HWY S BLDG II ST AUSTIN, TX 78746 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $904 | $904 | 0.91% |
| ASSUREDPARTNERS3 Filed as: BWD AGENCY INC | 45 EXECUTIVE DRIVE PLAINVIEW, NY 11803 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $73 | $4K | 7.12% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 1250 CAPITAL OF TX HWY S BLDG II ST AUSTIN, TX 78746 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $753 | $753 | 1.32% |
| DAVID KUSHNER3 | 45 EXECUTIVE DRIVE PLAINVIEW, NY 11803 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| ASSUREDPARTNERS3 Filed as: BWD AGENCY INC | 45 EXECUTIVE DRIVE PLAINVIEW, NY 11803 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $583 | — | $583 | 1.32% |
| DAVID KUSHNER3 | 16831 C ISLE OF PALMS DRIVE DELRAY BEACH, FL 33484 | SHELTERPOINT LIFE INSURANCE CO | $6K | — | $6K | 17.00% |
| THE DBL CENTER LTD3 Filed as: DBL CENTER LTD | 155 PINELAWN ROAD SUITE 120S MELVILLE, NY 11747 | SHELTERPOINT LIFE INSURANCE CO | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $340K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 THIRD PARTY ADMINISTRATOR | Named fiduciary; Direct payment from the plan; Participant communication; Other services; Float revenue; Contract Administrator; Non-monetary compensation; Claims processing Service code 12 | 900 COTTAGE GROVE RD. BLOOMFIELD, CT 06002 | $23K |
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 | 348 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 101 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 5 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 458 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 205 | $44K |
| Vision | SHELTERPOINT LIFE INSURANCE CO | 381 | $33K |
| Life insurance(2 contracts) | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 359 | $230K |
| Short-term disability | SHELTERPOINT LIFE INSURANCE CO | 400 | $135K |
| Long-term disability | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 359 | $136K |
| Other(5 contracts, 3 carriers) | SHELTERPOINT LIFE INSURANCE CO | 400 | $466K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 400 | — |
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.