| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT JACOBY3 | 148 MADISON AVENUE 15TH FLOOR NEW YORK, NY 10016 | AETNA LIFE INSURANCE COMPANY | $33K | — | $33K | 3.76% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BOULEVARD 2ND FLOOR HAUPPAUGE, NY 11788 | AETNA LIFE INSURANCE COMPANY | $22K | — | $22K | 2.51% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE AGENCY | 4851 LBJ FREEWAY, SUITE 100 DALLAS, TX 75244 | AETNA LIFE INSURANCE COMPANY | -$48 | — | -$48 | -0.01% |
| GROUP HEALTH SOLUTIONS INC3 Filed as: GROUP HEALTH SOLUTIONS, INC. | 148 MADISION AVENUE, 15TH FLOOR NEW YORK, NY 10016 | AETNA LIFE INSURANCE COMPANY | -$72 | — | -$72 | -0.01% |
| DONALD J. JACOBY3 | 5 SHOREDALE DRIVE MANHASSET, NY 10030 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $9K | $15K | 7.18% |
| ONOFRIO R CIRIANNI3 Filed as: ONOFRIO R. CIRIANNI | 5 RICHARDSON LANE BRIDGEWATER, NJ 08807 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 3.64% |
| INTERNATIONAL PLANNING ALLIANCE3 Filed as: INTERNATIONAL PLANNING ALLIANCE LLC | 300 BROADACRES DRIVE, SUITE 175 BLOOMFIELD, NJ 07003 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $668 | — | $668 | 0.31% |
| NMP PLANNING CO. INC3 Filed as: NMP PLANNING COMPANY, INC. | 118-35 QUEENS BOULEVARD SUITE 1230 FORREST HILLS, NY 11375 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $140 | — | $140 | 0.07% |
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 | 96 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 98 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 168 | $889K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $214K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $214K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $214K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $214K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $214K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 168 | $889K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $214K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 168 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.