| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PENTRA LLC3 Filed as: PENTRA, LLC | 795 E LANCASTER AVE SUITE 210 VILLANOVA, PA 19085 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $33K | $33K | 1.82% |
| MITCHELL B RUCKO3 | PO BOX 25 KINGSTON, NJ 08528 | AFLAC | $1K | $116 | $1K | 3.25% |
| DEBRA BURSTEIN RUCKO3 | PO BOX 25 KINGSTON, NJ 08528 | AFLAC | $817 | $18 | $835 | 2.21% |
| JOSHUA P SAUNDERS3 | 17 OAK LN RANDOLPH, NJ 07869 | AFLAC | $420 | $27 | $447 | 1.18% |
| TIMOTHY S HUCK3 | 6 BRENDAN DR FLANDERS, NJ 07836 | AFLAC | $381 | $0 | $381 | 1.01% |
| ELAINE GAUDY3 | 290 MAIN ST APT K MADISON, NJ 07940 | AFLAC | $296 | $27 | $323 | 0.85% |
| ALBERT SHUST3 | 200 CENTENNIAL AVE STE 105 PISCATAWAY, NJ 08854 | AFLAC | $126 | $0 | $126 | 0.33% |
| JESSICA A BOUTILETTE3 | 16 BROAD ST STE 5 WASHINGTON, NJ 07882 | AFLAC | $85 | $0 | $85 | 0.22% |
| JOSHUA PAUL GROUP INC3 | 17 OAK LN RANDOLPH, NJ 07869 | AFLAC | $82 | $0 | $82 | 0.22% |
| LONA N ONGARO3 | 16 TALBOT STREET SOMERSET, NJ 08873 | AFLAC | $63 | $0 | $63 | 0.17% |
| LONGA N ONGARO3 | 60 HENRY CT MOUNT ARLINGTON, NJ 07856 | AFLAC | $32 | $0 | $32 | 0.08% |
| ELAINE GAUDY3 | 150 ALLEN RD STE 110 BASKING RIDGE, NJ 07920 | AFLAC | $31 | $0 | $31 | 0.08% |
| TARA MICHELLE D AGOSTINO3 | 271 US HIGHWAY 46 STE D207 FAIRFIELD, NJ 07004 | AFLAC | $24 | $0 | $24 | 0.06% |
| MICHAEL A FORNARO3 | 271 US HIGHWAY 46 STE H119 FAIRFIELD, NJ 07004 | AFLAC | $17 | $0 | $17 | 0.04% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN A PITUCH | 60 US HIGHWAY 46 FAIRFIELD, NJ 07004 | AFLAC | $13 | $0 | $13 | 0.03% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN A PITUCH | 23 MORGAN DR SPARTA, NJ 07871 | AFLAC | $12 | $0 | $12 | 0.03% |
| REY ROSTAMI3 | PO BOX 625 STOCKHOLM, NJ 07460 | AFLAC | $9 | $0 | $9 | 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 | 7.31% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E. LANCASTER AVE #210 VILLANOVA, PA 19085 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.06% |
| PENTRA LLC3 Filed as: PENTRA, LLC | 795 E. LANCASTER AVE #210 VILLANOVA, PA 19085 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $215 | $0 | $215 | 1.80% |
| 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 | 14.96% |
| PENTRA LLC3 Filed as: PENTRA | 795 E LANCASTER AVE 2 VILLANOVA CTR #210 VILLANOVA, PA 19085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $197 | $0 | $197 | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE GUARDIAN LIFE INS CO OF AMERICA EIN 13-5123390 NONE | Claims processing; Contract Administrator Service code 12 | — | $9K |
| WAGEWORKS, INC. EIN 94-3351864 NONE | Claims processing; Contract Administrator Service code 12 | — | $473 |
| NATIONAL BENEFIT CENTER LLC NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | $12 |
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 | 199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 204 | 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 | 253 | $1.9M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 377 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 320 | $31K |
| Short-term disability | AFLAC | 48 | $38K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 215 | $11K |
| Other(4 contracts, 3 carriers) | AFLAC | 320 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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.