| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SVS LLC | 501 OFFICE CENTER DRIVE STE 215 FORT WASHINGTON, PA 19034 | DELTA DENTAL OF NEW JERSEY, INC. | $10K | — | $10K | 10.00% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BLVD. 2ND FLOOR HAUPPAUGE, NY 11788 | DELTA DENTAL OF NEW JERSEY, INC. | $5K | — | $5K | 5.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SVS LLC | 1460 US HIGHWAY 9 N STE 200 WOODBRIDGE, NJ 07095 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SVS LLC | 1460 US HIGHWAY 9 N STE 200 WOODBRIDGE, NJ 07095 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SVS LLC | 1460 US HIGHWAY 9 N STE 200 WOODBRIDGE, NJ 07095 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1460 US HIGHWAY 9 N STE 200 WOODBRIDGE, NJ 07095 | VISION SERVICE PLAN | $911 | — | $911 | 6.28% |
| YANIS E KALOUDIS3 Filed as: YANIS KALOUDIS | 45 DEAN ST WESTWOOD, NJ 07675 | AFLAC | $519 | — | $519 | 5.82% |
| TYLER KNIGHT3 | 190 PEQUEST RD BELVIDERE, NJ 07823 | AFLAC | $155 | — | $155 | 1.74% |
| MICHAEL P ZORN3 Filed as: MICHAEL ZORN | 10573 VERSAILLES BLVD WELLINGTON, FL 33449 | AFLAC | $148 | — | $148 | 1.66% |
| MICHAEL C WALKER3 Filed as: MICHAEL WALKER | 203 MARKET ST STE 201 HAVRE DE GRACE, MD 21078 | AFLAC | $119 | — | $119 | 1.33% |
| MATTHEW G BERGER3 Filed as: MATTHEW BERGER | 22 SUNNYRIDGE RD 4TH FLR PHILADELPHIA, PA 19125 | AFLAC | $58 | — | $58 | 0.65% |
| MICHAEL A FORNARO3 | 271 US HIGHWAY 46 SUITE H119 FAIRFIELD, NJ 07460 | AFLAC | $36 | — | $36 | 0.40% |
| ALBERT SHUST3 | 200 CENTENNIAL AVE STE 105 PISCATAWAY, NJ 08854 | AFLAC | $35 | — | $35 | 0.39% |
| DAVID MORNINGSTAR3 | 4281 BUCKSKIN WOOD DRIVE ELLICOTT CITY, MD 21042 | AFLAC | $20 | — | $20 | 0.22% |
| BETH E FREDERICKSON3 Filed as: BETH FREDERICKSON | 19 DAVENPORT RD MONTVILLE, NJ 07045 | AFLAC | $15 | — | $15 | 0.17% |
| ROBERT TOWNSEND3 | 34 SPRUCE ST #1 ELMWOOD PARK, NJ 07407 | AFLAC | $10 | — | $10 | 0.11% |
| AMY K FOY3 Filed as: AMY FOY | 804 MCCOY RD FRANKLIN LAKES, NJ 07417 | AFLAC | $9 | — | $9 | 0.10% |
| REY ROSTAMI3 | PO BOX 625 STOCKHOLM, NJ 07460 | AFLAC | $4 | — | $4 | 0.04% |
| TARA D AGOSTINO3 | 87A BOORAEM AVE JERSEY CITY, NJ 07307 | AFLAC | $4 | — | $4 | 0.04% |
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 | 156 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 251 | $97K |
| Vision | VISION SERVICE PLAN | 99 | $15K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 156 | $32K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 176 | $39K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 156 | $18K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 156 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.