| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 1.44% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 600 SYLVAN AVENUE, SUITE 301 ENGLEWOOD CLIFFS, NJ 07632 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $459 | $0 | $459 | 0.14% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFITS PROGRAMS, INC. | PO BOX 6718 SOMERSET, NJ 08875 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $93 | $0 | $93 | 0.03% |
| IMG3 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $65 | $65 | 0.02% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 600 SYLVAN AVENUE, SUITE 301 ENGLEWOOD CLIFFS, NJ 07632 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS CO. | $3K | $0 | $3K | 9.17% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 PASSAIC AVENUE, SUITE 120 FAIRFELD, NJ 07004 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS CO. | $3K | $0 | $3K | 9.17% |
| AON CONSULTING INC Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS CO. | $3K | $0 | $3K | 9.17% |
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 | 339 | 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) | 339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 544 | $365K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $328K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $328K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $328K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $328K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 544 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.