| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERNATIONAL BENEFITS ADMIN3 | 100 GARDEN CITY PLAZA GARDEN CITY, NY 11530 | XCHANGE BENEFITS | $53K | $0 | $53K | 11.82% |
| MBL BENEFITS CONSULTING CORP3 | 323 WEST 39TH STREET 11TH FLOOR NEW YORK, NY 10018 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 11.65% |
| FNA INSURANCE SERVICES INC3 | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $2K | $3K | 10.00% |
| MBL BENEFITS CONSULTING CORP3 | 323 WEST 39TH STREET 11TH FLOOR NEW YORK, NY 10018 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| FNA INSURANCE SERVICES INC3 | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | $1K | $2K | 10.00% |
| MBL BENEFITS CONSULTING CORP3 | 323 WEST 39TH STREET 11TH FLOOR NEW YORK, NY 10018 | VISION SERVICE PLAN | $416 | $0 | $416 | 3.28% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KINLOCH CONSULTING GROUP INC | 25 MELVILLE PARK RD STE 260 MELVILLE, NY 11747 | VISION SERVICE PLAN | $4 | $0 | $4 | 0.03% |
| FNA INSURANCE SERVICES INC3 | 180 RIVER ROAD FLOOR 2 SUMMIT, NJ 07901 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $115 | $4K | 31.91% |
| FNA INSURANCE SERVICES INC3 | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | FIRST UNUM LIFE INSURANCE COMPANY | $543 | $543 | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MBL BENEFITS CONSULTING CORP EIN 20-2930410 INDEPENDENT BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers; Consulting fees Service code 22 | 323 WEST 39TH STREET 11TH FLOOR NEW YORK, NY 10018 | $77K |
| INTERNATIONAL BENEFITS ADMINISTRATO EIN 11-3293162 CLAIMS PROCESSOR | Claims processing Service code 12 | 100 GARDEN CITY PLAZA GARDEN CITY, NY 11530 | $28K |
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 | 145 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 126 | $11K |
| Vision | VISION SERVICE PLAN | 96 | $13K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 145 | $58K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 122 | $11K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 145 | $35K |
| Stop-loss / reinsurancereinsurance | XCHANGE BENEFITS | 270 | $451K |
| Other(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 145 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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.