| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SAUL R LOCKER3 Filed as: SAUL EHRENFELD | 114 RICKY LANE LAKEWOOD, NJ 08701 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $43K | $43K | 2.50% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SVC LLC | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $34K | $34K | 2.00% |
| CREATIVE BUSINESS SOLUTIONS GRP INC3 | 4 GARDINER PLACE HUNTINGTON STATION, NY 11746 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $28K | $28K | 1.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $15K | $15K | 0.88% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS FIN SERVICES LLC | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $6K | $6K | 4.96% |
| EHERNFELD SAUL3 | 114 RICKY LN LAKEWOOD, NJ 08701 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 3.66% |
| CREATIVE BENEFIT SOLUTION3 Filed as: CREATIVE BUSINESS SOL GRP INC | 4 GARDINER PLACE HUNTINGTON STATION, NY 11746 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 2.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NOTHEAST LIMITED | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 1.58% |
| JASON M ANKER3 Filed as: JASON ANKER | 4 GARDINER PL HUNTINGTON STATION, NY 11746 | AFLAC | $3K | — | $3K | 2.91% |
| GAVIN MEIER3 | 14107 20 AVE STE 507 WHITESTONE, NY 11357 | AFLAC | $3K | $1 | $3K | 2.84% |
| LORI ANN LOMBARDO3 Filed as: LORI LOMBARDO | 459 TRESTLE WAY CONWAY, SC 29526 | AFLAC | $2K | $5 | $2K | 1.83% |
| RICHARD PETERSON3 | 19 IDLE DAY DR CENTERPORT, NY 11721 | AFLAC | $1K | $1 | $1K | 1.02% |
| PETER LOMBARDO3 | 63 BURLEIGH DR HOLBROOK, NY 11741 | AFLAC | $390 | $1 | $391 | 0.33% |
| JAMES R CLOSE3 Filed as: JAMES CLOSE | 419 SAINT CLAIR AVE SPRING LAKE, NJ 07762 | AFLAC | $191 | — | $191 | 0.16% |
| RBA BENEFITS GROUP INC.3 Filed as: RBA BENEFITS GROUP | 77 DRIFTWOOD DR BRICK, NJ 08723 | AFLAC | $180 | — | $180 | 0.15% |
| MICHAEL FORNARO3 | 271 US HIGHWAY 46 STE H119 FAIRFIELD, NJ 07004 | AFLAC | $73 | — | $73 | 0.06% |
| MICHAEL DIGIACOMO3 | 41 GROVE ST OAK RIDGE, NJ 07438 | AFLAC | $28 | — | $28 | 0.02% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN PITUCH | PO BOX 335 SPARTA, NJ 07871 | AFLAC | $28 | — | $28 | 0.02% |
| MICHAEL P ZORN3 Filed as: MICHAEL ZORN | 10573 VERSAILLES BLVD WELLINGTON, FL 33449 | AFLAC | $18 | — | $18 | 0.02% |
| ALBERT SHUST3 | 200 CENTENNIAL AVE STE 105 PISCATAWAY, NJ 08854 | AFLAC | $12 | — | $12 | 0.01% |
| BENEFITMALL3 | 1133 WESTCHESTER AVE STE 229 WHITE PLAINS, NY 10604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $2K | $4K | 9.58% |
| SAUL R LOCKER3 Filed as: SAUL EHRENFELD | 114 RICKY LN LAKEWOOD, NJ 08701 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.40% |
| CREATIVE BENEFIT SOLUTION3 | 4 GARDNIER PL HUNTINGTON STATION, NY 11746 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 5.74% |
| BENEFITMALL3 | 250 W OLD WILSON BRIDGE RD STE 190 WORTHINGTON, OH 43085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $188 | $188 | 0.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BLVD STE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $84 | — | $84 | 0.23% |
| LORI ANN LOMBARDO3 | 456 TRESTLE WAY CONWAY, SC 29526 | AFLAC | $406 | — | $406 | 9.28% |
| GFM CORP3 | 2 HALYARD CT COLD SPRING HARBOR, NY 11724 | AFLAC | $183 | — | $183 | 4.18% |
| RICHARD PETERSON3 | 19 IDLE DAY DR CENTERPORT, NY 11721 | AFLAC | $92 | — | $92 | 2.10% |
| CREATIVE BUSINESS SOLUTIONS GRP INC3 | 1114 MCDONALS AVE WANTAGH, NY 11793 | AFLAC | $84 | — | $84 | 1.92% |
| PETER LOMBARDO3 | 63 BURLEIGH DR HOLBROOK, NY 11741 | AFLAC | $36 | — | $36 | 0.82% |
| EHRENFELD S.3 Filed as: S EHRENFELD | 114 RICKY LN LAKEWOOD, NJ 08701 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $394 | — | $394 | 11.02% |
| BENEFITMALL3 | 1133 WESTCHESTER AVE STE 229 WHITE PLAINS, NY 10604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $164 | $179 | $343 | 9.59% |
| CREATIVE BENEFIT SOLUTION3 Filed as: CREATIVE BENEFIT SOL | 4 GARDNIER PL HUNTINGTON STATION, NY 11746 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $326 | — | $326 | 9.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SYNNYSIDE BLVD STE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19 | — | $19 | 0.53% |
| BENEFITMALL3 | 250 W OLD WILSON BRIDGE RD STE 190 WORTHINGTON, OH 43085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $18 | $18 | 0.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 MEDICAL CLAIMS PROCESSING | Claims processing Service code 12 | — | $86K |
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 | 215 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 193 | $1.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 136 | $128K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 136 | $128K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 6 | $37K |
| Other(3 contracts, 2 carriers) | AFLAC | 93 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.
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.