| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PENTRA LLC3 Filed as: PENTRA | 795 E LANCASTER AVE SUITE 210 VILLANOVA, PA 19085 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $41K | $41K | 1.96% |
| MITCHELL B RUCKO3 | PO BOX 25 KINGSTON, NJ 08528 | AFLAC | $3K | $481 | $4K | 7.95% |
| DEBRA BURSTEIN RUCKO3 | PO BOX 25 KINGSTON, NJ 08528 | AFLAC | $2K | $4 | $2K | 3.77% |
| JOSHUA P SAUNDERS3 | 17 OAK LN RANDOLPH, NJ 07869 | AFLAC | $1K | $98 | $1K | 2.33% |
| ELAINE GAUDY3 | 150 ALLEN RD STE 110 BASKING RIDGE, NJ 07920 | AFLAC | $788 | $0 | $788 | 1.66% |
| TIMOTHY S HUCK3 | 6 BRENDAN DR FLANDERS, NJ 07836 | AFLAC | $665 | $98 | $763 | 1.60% |
| MICHAEL A FORNARO3 | 271 US HIGHWAY 46 STE H119 FAIRFIELD, NJ 07004 | AFLAC | $406 | $0 | $406 | 0.85% |
| ALBERT SHUST3 | 200 CENTENNIAL AVE STE 105 PISCATAWAY, NJ 08854 | AFLAC | $243 | $98 | $341 | 0.72% |
| LONA N ONGARO3 | 16 TALBOT STREET SOMERSET, NJ 08873 | AFLAC | $264 | $0 | $264 | 0.56% |
| JESSICA A BOUTILETTE3 | 16 BROAD ST STE 5 WASHINGTON, NJ 07882 | AFLAC | $107 | $0 | $107 | 0.22% |
| KEVIN J NIEDERAUER3 | 150 ALLEN RD STE 110 BASKING RIDGE, NJ 07920 | AFLAC | $12 | $0 | $12 | 0.03% |
| JESSICA A BOUTILETTE3 | 1 W CHURCH ST STAR PLAZA SUITE 2 WASHINGTON, NJ 07882 | AFLAC | $10 | $0 | $10 | 0.02% |
| PENTRA LLC3 Filed as: PENTRA | 795 E LANCASTER AVE 2 VILLANOVA CTR #210 VILLANOVA, PA 19085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 7.52% |
| PENTRA LLC3 Filed as: PENTRA, INC. | AKA INTEGRATED BEN SVCS 795 E. LANCASTER AVE #210 VILLANOVA, PA 19085 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| PENTRA LLC3 Filed as: PENTRA | 795 E LANCASTER AVE 2 VILLANOVA CTR #210 VILLANOVA, PA 19085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 15.00% |
| PENTRA LLC3 Filed as: PENTRA | 795 E LANCASTER AVE 2 VILLANOVA CTR #210 VILLANOVA, PA 19085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $173 | $0 | $173 | 12.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE GUARDIAN LIFE INS CO OF AMERICA EIN 13-5123390 NONE | Contract Administrator; Claims processing Service code 12 | — | $8K |
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 | 172 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 266 | $2.1M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 373 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 232 | $31K |
| Short-term disability | AFLAC | 62 | $48K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 202 | $9K |
| Other(3 contracts, 3 carriers) | AFLAC | 202 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 373 | — |
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."
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.