| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDWARD LEE3 | 16835 W. BERNARDO DRIVE, STE 212 SAN DIEGO, CA 921270000 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $66K | $5K | $71K | 3.10% |
| GFI INSURANCE BROKERAGE3 Filed as: GFI INSURANCE BROKERAGE INC. | 140 BROADWAY, 41ST FL NEW YORK, NY 10004 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $31K | — | $31K | 1.34% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SERV (NY) | 1133 WESTCHESTER AVENUE, SUITE 229 WHITE PLAINS, NY 106040000 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | — | $16K | $16K | 0.68% |
| E LEE & ASSOCIATES INC.3 | 16835 WEST BERNARDO DR, SUITE 212 SAN DIEGO, CA 92127 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | — | $5K | $5K | 0.22% |
| USI INSURANCE SERVICES LLC3 | 6TH FLOOR 261 MADISON AVE NEW YORK, NY 10016 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 3.30% |
| EDWARD LEE3 | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 921271612 | VISION SERVICE PLAN | $1K | — | $1K | 5.00% |
| GFI INSURANCE3 Filed as: GFI INSURANCE SERVICES INC. | 140 BROADWAY FL 41 NEW YORK, NY 10005 | VISION SERVICE PLAN | $54 | — | $54 | 0.24% |
| EDWARD LEE3 | 16835 W BERNARDO DRIVE, STE 212 SAN DIEGO, CA 921270000 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $657 | — | $657 | 6.84% |
| GFI INSURANCE BROKERAGE3 Filed as: GFI INSURANCE BROKERAGE INC. | 140 BROADWAY, 41ST FL NEW YORK, NY 10004 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $303 | — | $303 | 3.16% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SERV (NY) | 1133 WESTCHESTER AVENUE, SUITE 229 WHITE PLAINS, NY 106040000 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | — | $121 | $121 | 1.26% |
| USI INSURANCE SERVICES LLC3 | 6TH FLOOR 261 MADISON AVE NEW YORK, NY 10016 | FIRST UNUM LIFE INSURANCE COMPANY | $254 | — | $254 | 3.79% |
| EDWARD LEE3 | 16835 W BERNARDO DRIVE, STE 212 SAN DIEGO, CA 921270000 | CIGNA DENTAL HEALTH OF NEW JERSEY, INC. | $150 | — | $150 | 6.85% |
| GFI INSURANCE BROKERAGE3 Filed as: GFI INSURANCE BROKERAGE INC. | 140 BROADWAY, 41ST FL NEW YORK, NY 10004 | CIGNA DENTAL HEALTH OF NEW JERSEY, INC. | $69 | — | $69 | 3.15% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SERV (NY) | 1133 WESTCHESTER AVENUE, SUITE 229 WHITE PLAINS, NY 106040000 | CIGNA DENTAL HEALTH OF NEW JERSEY, INC. | — | $28 | $28 | 1.28% |
| EDWARD LEE3 | 16835 W BERNARDO DRIVE, STE 212 SAN DIEGO, CA 921270000 | CIGNA DENTAL HEALTH OF ILLINOIS, INC. | $69 | — | $69 | 6.82% |
| GFI INSURANCE BROKERAGE3 Filed as: GFI INSURANCE BROKERAGE INC. | 140 BROADWAY, 41ST FL NEW YORK, NY 10004 | CIGNA DENTAL HEALTH OF ILLINOIS, INC. | $32 | — | $32 | 3.17% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SERV (NY) | 1133 WESTCHESTER AVENUE, SUITE 229 WHITE PLAINS, NY 106040000 | CIGNA DENTAL HEALTH OF ILLINOIS, INC. | — | $13 | $13 | 1.29% |
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 | 222 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 188 | $2.3M |
| Dental(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 188 | $2.3M |
| Vision | VISION SERVICE PLAN | 125 | $23K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 209 | $100K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 209 | $93K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 209 | $93K |
| Other(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 209 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.