| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MBL BENEFITS CONSULTING CORP3 | 323 WEST 39TH STREET 11TH FLOOR NEW YORK, NY 10018 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 4.97% |
| GREATER METRO AGENCY INC3 | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 3.42% |
| MBL BENEFITS CONSULTING CORP3 Filed as: MBL BENEFITS CONSULTING | 323 WEST 39TH STREET 11TH FLOOR NEW YORK, NY 10018 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $3K | — | $3K | 13.29% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES | 1000 WOODBURY ROAD 4TH FLOOR SUITE 403 WOODBURY, NY 11797 | CIGNA LIFE INSURANCE CO. OF NEW YORK | — | $1K | $1K | 5.00% |
| MBL BENEFITS CONSULTING CORP3 Filed as: MBL BENEFITS CONSULTING | 323 WEST 39TH STREET 11TH FLOOR NEW YORK, NY 10018 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $2K | — | $2K | 9.17% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES | 1000 WOODBURY ROAD 4TH FLOOR SUITE 403 WOODBURY, NY 11797 | CIGNA LIFE INSURANCE CO. OF NEW YORK | — | $964 | $964 | 5.00% |
| MBL BENEFITS CONSULTING CORP3 Filed as: MBL BENEFITS CONSULTING | 323 WEST 39TH STREET 11TH FLOOR NEW YUORK, NY 10018 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $615 | — | $615 | 11.98% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES | 1000 WOODBURY ROAD 4TH FLOOR SUITE 403 WOODBURY, NY 11797 | CIGNA LIFE INSURANCE CO. OF NEW YORK | — | $257 | $257 | 5.01% |
| RAYMOND J KOBER3 | 14107 20TH AVENUE SUITE 507 WHITESTONE, NY 11357 | AFLAC | $474 | $14 | $488 | 10.82% |
| MARC B LEVY3 | 18 TRAFALGAR DRIVE LIVINGSTON, NJ 07039 | AFLAC | $165 | — | $165 | 3.66% |
| KOBER ASSOCIATES LLC3 | 14107 20TH AVENUE SUITE 507 WHITESTONE, NY 11357 | AFLAC | $708 | $46 | $754 | 20.01% |
| MBL BENEFITS CONSULTING CORP3 Filed as: MBL BENEFIT CONSULTING CORP | 323 WEST 39TH STREET FLOOR 11 NEW YORK, NY 10018 | AFLAC | $451 | — | $451 | 11.97% |
| RICHARD PETERSON3 | 14107 20TH AVENUE SUITE 507 WHITESTONE, NY 11357 | AFLAC | $155 | $13 | $168 | 4.46% |
| MBL BENEFITS CONSULTING CORP3 Filed as: MBL BENEFITS CONSULTING | 323 WEST 39TH STREET 11TH FLOOR NEW YORK, NY 10018 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $96 | — | $96 | 9.98% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: FNA ISNURANCE SERVICES | 1000 WOODBURY ROAD 4TH FLOOR SUITE 403 WOODBURY, NY 11797 | CIGNA LIFE INSURANCE CO. OF NEW YORK | — | $48 | $48 | 4.99% |
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 77 | $93K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 77 | $93K |
| Life insurance(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 100 | $9K |
| Short-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 100 | $19K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 100 | $23K |
| Other(3 contracts, 2 carriers) | AFLAC | 100 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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.