| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPACITY BENEFITS & FINANCIAL SERV3 | 1 INTERNATIONAL BLVD MAHWAH, NJ 07495 | CIGNA HEALTH AND LIFE INS CO AND AFFILIATES | $60K | — | $60K | 5.00% |
| CAPACITY BENEFITS & FINANCIAL SERVI3 Filed as: CAPACITY BENEFITS GROUP INC | 1 INTERNATIONAL BLVD STE 340 MAHWAH, NJ 07495 | DELTA DENTAL OF NJ INC | $330 | — | $330 | 2.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BELINDA BONNANO EIN 22-3242464 OFFICE HELP | Employee (plan) Service code 30 | 11 BOBOLINK CT WAYNE, NJ 07470 | $20K |
| ORANSKY, SCARAGGI & BORG EIN 22-3522685 LAWYER | Legal Service code 29 | 175 FAIRFIELD AVE STE 1A WEST CALDWELL, NJ 07007 | $12K |
| BRUNO DIBELLO & CO. LLC EIN 22-2414251 ACCOUNTANT | Accounting (including auditing) Service code 10 | 785 TOTOWA RD TOTOWA, NJ 07512 | $11K |
| CIGNA HEALTH AND LIFE INS COMPANY EIN 59-1031071 CLAIM ADMIN PUR TO ASA | Other services; Participant communication; Contract Administrator; Claims processing; Float revenue; Named fiduciary; Non-monetary compensation; Direct payment from the plan Service code 12 | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | $6K |
| BELINDA BONNANO 22-3242464 | Other fees Service code 99 | — | $0 |
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 | 85 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INS CO AND AFFILIATES | 185 | $1.2M |
| Dental | DELTA DENTAL OF NJ INC | 0 | $14K |
| Vision | CIGNA HEALTH AND LIFE INS CO AND AFFILIATES | 185 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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.