| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS (NJ) | 4851 LBJ FWY SUITE 100 DALLAS, TX 75244 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $20K | $20K | 9.65% |
| CAPACITY BENEFITS & FINANCIAL SERVI3 Filed as: CAPACITY BENEFITS FIN SERV GRP LLC | ONE INTERNATIONAL BLVD MAHWAH, NJ 07495 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | $8K | $19K | 8.94% |
| THE DBL CENTER LTD3 Filed as: DBL CENTER LTD | 555 BROADHOLLOW ROAD SUITE 271 MELVILLE, NY 11747 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 1.99% |
| THE D B L CENTER LTD3 | 555 BROADHOLLOW ROAD MELVILLE, NY 11747 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $5K | $5K | $9K | 16.00% |
| COMBINED DBL RESOURCES LTD3 | 555 BROADHOLLOW ROAD SUITE 271 MELVILLE, NY 11747 | VISION SERVICE PLAN | $1K | — | $1K | 5.00% |
| THE D B L CENTER LTD3 | 555 BROADHOLLOW ROAD MELVILLE, NY 11747 | LINCOLN LIFE & ANNUITY COMPANY | $2K | $2K | $4K | 18.08% |
| THE D B L CENTER LTD3 Filed as: THE D B L CENTER | 555 BROADHOLLOW ROAD MELVILLE, NY 11747 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $2K | $1K | $4K | 23.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 SERVICE PROVIDER | Float revenue; Claims processing; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Other services; Contract Administrator Service code 12 | — | $204K |
| CAPACITY BNFT AND FIN SVCS GRP LLC BROKER/AGENT | Other services Service code 49 | ONE INTERNATIONAL DRIVE MAHWAH, NJ 07495 | $110K |
| CENERSTONE INS NJ BROKER/AGENT | Other services Service code 49 | 354 EISENHOWER PARKWAY SUTE 2850 LIVINGSTON, NJ 07039 | $44K |
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 | 519 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 519 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 292 | $225K |
| Vision | VISION SERVICE PLAN | 256 | $22K |
| Life insurance(2 contracts, 2 carriers) | LINCOLN LIFE & ANNUITY COMPANY | 519 | $37K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 265 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 519 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.