| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS. SERVICE | 320 W 57TH STREET NEW YORK, NY 10019 | CIGNA HEALTH AND LIFE INS. CO. | $21K | — | $21K | 7.13% |
| HEALTH BUSINESS GROUP LLC3 | 34 BAY STREET SUITE 202 SAG HARBOR, NY 11923 | CIGNA HEALTH AND LIFE INS. CO. | $0 | $13K | $13K | 4.63% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 320 W 57TH STREET 3RD. FLOOR NEW YORK, NY 10019 | LIFE INSURANCE CO. OF NORTH AMERICA | $2K | — | $2K | 11.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS, CO. EIN 59-1031071 ADMINISTRATOR | Claims processing; Plan Administrator; Contract Administrator Service code 12 | — | $273K |
| ALLEGIANCE BENEFIT PLAN MANNAGEMENT EIN 81-0400550 CLAIMS ADMINISTRATOR | Claims processing; Plan Administrator Service code 12 | — | $57K |
| MAHON, MCKENZIE & COLSON CPAS EIN 46-3729406 AUDITOR | Accounting (including auditing) Service code 10 | 2444 HWY 34 SUITE C MANASQUAN, NJ 08730 | $12K |
| STARPOINT LLC EIN 03-0507057 CASE MANAGER | Contract Administrator Service code 13 | — | $12K |
| MORGAN STANLEY EIN 26-4310632 RIA | Other commissions; Other services; Securities brokerage; Direct payment from the plan; Other investment fees and expenses; Investment advisory (plan) Service code 27 | 55 BROAD STREET RED BANK, NJ 07701 | $11K |
| BMI AUDIT SERVICES EIN 35-2051914 AUDITOR | Accounting (including auditing) Service code 10 | — | $5K |
| CIGNA HEALTH & LIFE INS. CO. | Claims processing; Contract Administrator; Direct payment from the plan; Participant communication; Float revenue; Other services; Non-monetary compensation; Named fiduciary Service code 12 | — | $0 |
| CIGNA HEALTH AND LFE INS. CO. | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Named fiduciary; Non-monetary compensation; Float revenue 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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUN LIFE ASSURANCE CO. OF CANADA | 250 | $869K |
| Life insurance | LIFE INSURANCE CO. OF NORTH AMERICA | 197 | $20K |
| Long-term disability | LIFE INSURANCE CO. OF NORTH AMERICA | 197 | $20K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE CO. OF CANADA | 250 | $869K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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.