| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP ADVISORY INC3 | 1135 CLIFTON AVE STE 201 CLIFTON, NJ 07013 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $107K | $0 | $107K | 10.95% |
| GROUP ADVISORY INC3 | 1135 CLIFTON AVE STE 201 CLIFTON, NJ 07013 | DELTA DENTAL OF NEW JERSEY, INC | $10K | $0 | $10K | 5.01% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE,INC | 700 AIRPORT BLVD STE 300 BURLINGAME, CA 94010 | UNITED OF OMAHA LIFE INSUARNCE COMPANY | $4K | $0 | $4K | 6.92% |
| SELMAN & COMPANY, LLC3 | 1 INTEGRITY PKWY CLEVELAND, OH 44143 | UNITED OF OMAHA LIFE INSUARNCE COMPANY | $0 | $2K | $2K | 3.46% |
| GROUP ADVISORY INC3 Filed as: GROUP ADVISORY, INC | 1135 CLIFTON AVE STE 201 CLIFTON, NJ 07013 | UNITED OF OMAHA LIFE INSUARNCE COMPANY | $2K | $0 | $2K | 3.08% |
| GROUP ADVISORY INC3 Filed as: GROUP ADVISORY, INC | 1135 CLIFTON AVE STE 201 CLIFTON, NJ 07013 | UNITED OF OMAHA LIFE INSUARNCE COMPANY | $2K | $0 | $2K | 5.19% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE,INC. | 700 AIRPORT BLVD STE 300 BURLINGAME, CA 94010 | UNITED OF OMAHA LIFE INSUARNCE COMPANY | $2K | $0 | $2K | 5.19% |
| SELMAN & COMPANY, LLC3 | 1 INTEGRITY PKWY CLEVELAND, OH 44143 | UNITED OF OMAHA LIFE INSUARNCE COMPANY | $0 | $2K | $2K | 3.27% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC | 160 FEDERAL ST 4TH FL BOSTON, MA 02110 | VISION SERVICE PLAN | $839 | $0 | $839 | 3.50% |
| ARISTA INVESTORS CORP3 | 25 NEWBRIDGE RD.-STE 310 HICKSVILLE, NY 11801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $367 | $219 | $586 | 5.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMINISTRATOR | Claims processing; Contract Administrator; Float revenue; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan; Other services Service code 12 | — | $100K |
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 | 268 | 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) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 128 | $974K |
| Dental | DELTA DENTAL OF NEW JERSEY, INC | 170 | $196K |
| Vision | VISION SERVICE PLAN | 164 | $24K |
| Life insurance | UNITED OF OMAHA LIFE INSUARNCE COMPANY | 268 | $54K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 24 | $11K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSUARNCE COMPANY | 268 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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.