| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED COMMUNITY BROKERS, LLC3 Filed as: ASSOCIATED COMMUNITY BROKERS INC. | 2150 POST RD 4TH FL FAIRFIELD, CT 068245669 | VISION SERVICE PLAN | $7K | — | $7K | 1.17% |
| ASSOCIATED COMMUNITY BROKERS, LLC3 | 2150 POST RD FAIRFIELD, CT 06824 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $50K | — | $50K | 15.52% |
| RABINOWITZ, SEAN J3 | 7 5TH AVENUE BRANFORD, CT 06405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $42K | — | $42K | 12.92% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST. HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $554 | $13K | 4.08% |
| ASSOCIATED COMMUNITY BROKERS, LLC3 | 2150 POST RD FAIRFIELD, CT 06824 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $65K | — | $65K | 37.45% |
| RABINOWITZ, SEAN J3 | 7 5TH AVENUE BRANFORD, CT 06405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18K | — | $18K | 10.44% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 4.16% |
| ASSOCIATED COMMUNITY BROKERS, LLC3 | 2150 POST ROAD FAIRFIELD, CT 06824 | FEDERAL INSURANCE COMPANY | $23K | $5K | $28K | 18.00% |
| ASSOCIATED COMMUNITY BROKERS, LLC3 | 2150 POST ROAD FAIRFIELD, CT 06824 | FEDERAL INSURANCE COMPANY | $7K | $1K | $9K | 18.00% |
| ASSOCIATED COMMUNITY BROKERS, LLC3 | 2150 POST RD FAIRFIELD, CT 06824 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 25.15% |
| RABINOWITZ, SEAN J3 | 7 5TH AVENUE BRANFORD, CT 06405 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 23.78% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $145 | — | $145 | 2.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS CAREMARK EIN 05-0340626 ADMIN SERVICES AGREEMENT | Participant communication; Other services; Contract Administrator; Non-monetary compensation; Named fiduciary; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $15.7M |
| CIGNA EIN 59-1031071 ADMIN SERVICES AGREEMENT | Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Other services; Named fiduciary; Participant communication; Non-monetary compensation Service code 12 | — | $3.6M |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $37K |
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 | 5,778 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 110 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 76 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,964 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NJ, INC. | 5,000 | $4.4M |
| Vision | VISION SERVICE PLAN | 4,315 | $591K |
| Life insurance | AETNA LIFE INSURANCE CO. | 5,789 | $4.4M |
| Short-term disability | AETNA LIFE INSURANCE CO. | 5,789 | $4.4M |
| Long-term disability | AETNA LIFE INSURANCE CO. | 5,789 | $4.4M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 0 | $0 |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 8,804 | $707K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,804 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.