| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, LLC | 200 EAST PARK DRIVE, SUITE 600 MOUNT LAUREL, NJ 08054 | HARTFORD LIFE INSURANCE COMPANY | $14K | $924 | $15K | 11.28% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, LLC | PO BOX 654118 DALLAS, TX 75265 | VISION SERVICE PLAN | $1K | — | $1K | 5.62% |
| MJ INSURANCE3 Filed as: KEN MEIER CORP. AND VARIOUS AGENTS | 401 FRANKLIN AVENUE, SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $170 | $9 | $179 | 3.25% |
| MICHAEL BURACK3 | 125 JERICHO TURNPIKE, SUITE 201 JERICHO, NY 11753 | AFLAC | $165 | — | $165 | 2.99% |
| YAMILKY N. CRISOSTOMO TAVERAS3 | 1272 JEFFERSON AVENUE BROOKLYN, NY 11221 | AFLAC | $97 | $13 | $110 | 2.00% |
| PATRICK RUHLE3 Filed as: PATRICK C. HARDIE | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $64 | — | $64 | 1.16% |
| TRACY L WILBANKS3 Filed as: TRACY L. WILBANKS | 446 WEST 55TH STREET APARTMENT 2B NEW YORK, NY 10019 | AFLAC | $64 | — | $64 | 1.16% |
| STEPHEN WHITE3 | 214 25 42ND AVENUE, 4TH FLOOR BAYSIDE, NY 11361 | AFLAC | $59 | — | $59 | 1.07% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, LLC | 5000 DEARBORN AVENUE, SUITE 100 MOUNT LAUREL, NJ 08054 | AFLAC | $46 | — | $46 | 0.83% |
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 | 257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 437 | $432K |
| Vision | VISION SERVICE PLAN | 151 | $19K |
| Life insurance | HARTFORD LIFE INSURANCE COMPANY | 264 | $136K |
| Short-term disability | FEDERAL INSURANCE COMPANY | 257 | $0 |
| Long-term disability | HARTFORD LIFE INSURANCE COMPANY | 264 | $136K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 437 | $432K |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE INSURANCE COMPANY | 287 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 437 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.