| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED COMMUNITY BROKERS, LLC3 Filed as: ASSOCIATED COMMUNITY BROKERS INC. | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 1.99% |
| ASSOCIATED COMMUNITY BROKERS, LLC3 | PO BOX 1388 BANGOR, ME 04402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24K | — | $24K | 7.94% |
| RABINOWITZ, SEAN J3 | 7 5TH AVENUE BRANFORD, CT 06405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24K | — | $24K | 7.83% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST. HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $506 | — | $506 | 0.16% |
| ACBI, INC.3 Filed as: ACBI, INC | PO BOX 1388 BANGOR, ME 04402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25K | — | $25K | 12.83% |
| RABINOWITZ, SEAN J3 | 7 5TH AVENUE BRANFORD, CT 06405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21K | — | $21K | 10.63% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $581 | $2K | 0.86% |
| ASSOCIATED COMMUNITY BROKERS, LLC3 | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | FEDERAL INSURANCE COMPANY | $423 | — | $423 | 0.25% |
| ASSOCIATED COMMUNITY BROKERS, LLC3 | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | FEDERAL INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| ACBI, INC.3 Filed as: ACBI INSURANCE | 2150 POST RD FAIRFIELD, CT 06824 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| ACBI, INC.3 Filed as: ACBI, INC | PO BOX 1388 BANGOR, ME 04402 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 26.69% |
| RABINOWITZ, SEAN J3 | 7 5TH AVENUE BRANFORD, CT 06405 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 26.38% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $56 | — | $56 | 0.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS CAREMARK EIN 05-0340626 ADMIN SERVICES AGREEMENT | Non-monetary compensation; Claims processing; Participant communication; Contract Administrator; Named fiduciary; Direct payment from the plan; Other services; Float revenue Service code 12 | — | $16.3M |
| CIGNA EIN 59-1031071 ADMIN SERVICES AGREEMENT | Other services; Named fiduciary; Float revenue; Claims processing; Participant communication; Contract Administrator; Direct payment from the plan; Non-monetary compensation Service code 12 | — | $3.9M |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $24K |
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 | 5,445 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 68 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 237 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,750 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2 | $15K |
| Dental | DELTA DENTAL OF NJ, INC. | 10,337 | $3.5M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 9,734 | $600K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 7,997 | $4.3M |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 7,997 | $4.3M |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 7,997 | $4.3M |
| Other(6 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 7,997 | $3.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,337 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.