| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RONALD L ROSENBERG3 | 1001 READS LANE FAR ROCKAWAY, NY 11691 | UNITEDHEALTHCARE INSURANCE COMPANY | $24K | — | $24K | 4.50% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $5K | $5K | 0.87% |
| FNA INSURANCE SERVICES INC3 | 180 RIVER ROAD FLOOR 2 SUMMIT, NJ 07901 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $773 | $4K | 15.33% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS | 700 KINDERKAMACK ROAD SUITE 205 ORADELL, NJ 07649 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.02% |
| RONALD L ROSENBERG3 | 1001 READS LANE FAR ROCKAWAY, NY 11691 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | — | $3K | 12.29% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS | 700 KINDERKAMACK ROAD SUITE 205 ORADELL, NJ 07649 | TRANSAMERICA LIFE INSURANCE COMPANY | $824 | — | $824 | 3.19% |
| RONALD L ROSENBERG3 | 1001 READS LANE FAR ROCKAWAY, NY 11691 | TRANSAMERICA LIFE INSURANCE COMPANY | $674 | — | $674 | 2.61% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS | 700 KINDERKAMACK ROUD SUITE 205 ORADELL, NJ 07649 | TRANSAMERICA LIFE INSURANCE COMPANY | $601 | — | $601 | 2.33% |
| RONALD L ROSENBERG3 | 1001 READS LANE FAR ROCKAWAY, NY 11691 | TRANSAMERICA LIFE INSURANCE COMPANY | $491 | — | $491 | 1.90% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS | 700 KINDERKAMACK ROAD SUITE 205 ORADELL, NJ 07649 | TRANSAMERICA LIFE INSURANCE COMPANY | $406 | — | $406 | 1.57% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS | 700 KINDERKAMACK ROAD SUITE 205 ORADELL, NJ 07649 | TRANSAMERICA LIFE INSURANCE COMPANY | $352 | — | $352 | 1.36% |
| RONALD L ROSENBERG3 | 1001 READS LANE FAR ROCKAWAY, NY 11691 | TRANSAMERICA LIFE INSURANCE COMPANY | $332 | — | $332 | 1.28% |
| RONALD L ROSENBERG3 | 1001 READS LANE FAR ROCKAWAY, NY 11691 | TRANSAMERICA LIFE INSURANCE COMPANY | $288 | — | $288 | 1.11% |
| RONALD ROSENBERG3 | 1001 READS LANE FAR ROCKAWAY, NY 11691 | METROPOLITAN LIFE INSURANCE COMPANY | $443 | — | $443 | 17.57% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INS SERVICES INC | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | METROPOLITAN LIFE INSURANCE COMPANY | $117 | — | $117 | 4.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | METROPOLITAN LIFE INSURANCE COMPANY | — | $59 | $59 | 2.34% |
| ENROLLEASE3 Filed as: ENROLLEASE INC | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | METROPOLITAN LIFE INSURANCE COMPANY | — | $47 | $47 | 1.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | METROPOLITAN LIFE INSURANCE COMPANY | — | $7 | $7 | 0.28% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 34 | $544K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 18 | $26K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 18 | $26K |
| Life insurance(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 125 | $28K |
| Short-term disability | TRANSAMERICA LIFE INSURANCE COMPANY | 19 | $26K |
| Other(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 125 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.