| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PEQUOT PLUS HEALTH SERVICES5 | ONE ANNIE GEORGE DR. BUILDING 2 MASHANTUCKET, CT 06338 | AMERICAN NATIONAL INS. CO. | $0 | — | $0 | 0.00% |
| CAI INSURANCE AGENCY INC3 Filed as: CAI BENEFITS, INC | 120 EAGLE ROCK AVENUE 2ND FLOOR EAST HANOVER, NJ 07936 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | — | $11K | 10.76% |
| COMMUNITY INVESTMENT SERVICES, INC.3 | 201 N UNION STREET PO BOX 690 OLEAN, NY 14760 | PRINCIPAL LIFE INS. CO. | $3K | $305 | $3K | 6.90% |
| CAI INSURANCE AGENCY INC3 Filed as: CAI BENEFITS, INC. | 120 EAGLE ROCK AVENUE EAST HANOVER, NJ 07936 | UNUM LIFE INSURANCE CO. OF AMERICA | $3K | — | $3K | 8.09% |
| COMMUNITY INVESTMENT SERVICES, INC.3 | 120 EAGLE ROCK AVENUE EAST HANOVER, NJ 07936 | VISION SERVICE PLAN | $2K | — | $2K | 4.35% |
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 | 209 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 207 | $35K |
| Life insurance(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $185K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $107K |
| Stop-loss / reinsurancereinsurance | AMERICAN NATIONAL INS. CO. | 193 | $321K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $185K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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."
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.