| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BLVD, 2ND FLOOR HAUPPAUGE, NY 11788 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 3.95% |
| CAMPBELL PETRIE, INC.3 Filed as: CAMPBELL PETRIE INC. | 570 W. MOUNT PLEASANT AVE SUITE 104 LIVINGSTON, NJ 07039 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $1K | $5K | 15.29% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS INC. | 225 WIRELESS BLVD SUITE 200 HAUPPAUGE, NY 11788 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1030171 CLAIMS ADMINISTRATOR | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Actuarial Service code 11 | — | $53K |
| CAMBELL PETRIE, INC. BROKER | Insurance services; Insurance agents and brokers; Consulting (general) Service code 16 | 570 W. MOUNT PLEASANT DRIVE LIVINGSTON, NJ 07039 | $47K |
| PROFESSIONAL GROUP PLANS, INC. GENERAL AGENT | Consulting (general); Insurance agents and brokers; Insurance services Service code 16 | 225 WIRELESS BOULEVARD, 2ND FLOOR HAUPPAUGE, NY 11788 | $43K |
| CIGNA HEALTH AND LIFE INSURANCE CO | Other services; Named fiduciary; Float revenue; Claims processing; Participant communication; Contract Administrator; Direct payment from the plan; Non-monetary compensation Service code 12 | — | $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 | 173 | 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) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 165 | $69K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 173 | $31K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 173 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.