| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OTTERSTEDT INS AGENCY INC3 Filed as: OTTERSTEDT INSURANCE AGENCY | 540 SYLVAN AVENUE ENGLEWOOD CLIFFS, NJ 07632 | CIGNA HEALTH & LIFE INSURANCE COMPANY | — | $130K | $130K | 1.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES, INC | ROUND TABLE STUDIOS 200 CONNELL DR BERKELEY HTS, NJ 07922 | CIGNA HEALTH & LIFE INSURANCE COMPANY | — | $67K | $67K | 0.77% |
| DONALD C SAVOY INC3 Filed as: DONALD C. SAVOY INC | ROUND TABLE STUDIOS 200 CONNELL DR #1000 BERKELEY HEIGHTS, NJ 07922 | CIGNA HEALTH & LIFE INSURANCE COMPANY | — | $63K | $63K | 0.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES INC. | ROUND TABLE STUDIOS 200 CONNELL DRIVE SUITE 100 BERKELEY HTS, NJ 07922 | GUARDIAN | $124K | $21K | $145K | 12.70% |
| OTTERSTEDT INS AGENCY INC3 Filed as: OTTERSTEDT INSURANCE AGENCY INC | 540 SYLVAN AVENUE ENGELWOOD CLIFFS, NJ 07632 | METLIFE LEGAL PLANS | $7K | — | $7K | 6.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 900 COTTAGE GROVE RD BLOOMFIELD, CA 06002 | $155K |
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 | 785 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 793 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 776 | $8.7M |
| Dental | GUARDIAN | 785 | $1.1M |
| Vision | GUARDIAN | 785 | $1.1M |
| Life insurance | GUARDIAN | 785 | $1.1M |
| Short-term disability | GUARDIAN | 785 | $1.1M |
| Long-term disability | GUARDIAN | 785 | $1.1M |
| Other(2 contracts, 2 carriers) | GUARDIAN | 785 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 785 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.