| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 1460 ROUTE 9 NORTH STE 310 WOODBRIDGE, NJ 07095 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $14K | $14K | 1.14% |
| PHOENIX INSURANCE GROUP, INC.3 Filed as: PHOENIX INSURANCE GROUP INC | 205 MAIN STREET CHESTER, NJ 07930 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 0.23% |
| EMERSON REID LLC3 Filed as: EMERSON REID & COMPANY, INC | 1787 SENTRY PKWY W VEVA 16 STE 320 BLUE BELL, PA 19422 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $2K | $2K | 0.16% |
| ACRISURE LLC3 | D/B/A GARCEAU INSURANCE AGENCY PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $2K | $12K | 6.67% |
| GIS BENEFITS INC3 | 2520 NORTHWINDS PKWY STE 600 ALPHARETTA, GA 30009 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | — | $9K | 4.93% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 1.45% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $394 | $2K | 0.87% |
| PHOENIX INSURANCE GROUP, INC.3 Filed as: PHOENIX INS GROUP INC | 205 MAIN ST CHESTER, NJ 07930 | METROPOLITAN LIFE INSURANCE COMPANY | $566 | — | $566 | 0.32% |
| WORKSITE WHEELHOUSE3 Filed as: WORKSITE WHEELHOUSE LLC | 103-107 CHURCH ST 3 PHILADELPHIA, PA 19106 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 21.35% |
| ACRISURE LLC3 | 505 THORNALL STREET EDISON, NJ 08837 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 6.67% |
| BRADLEY K BIEL3 | 225 GRAND ST APT 706 JERSEY CITY, NJ 07302 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 6.01% |
| GA SOLUTIONS LLC3 | 65 MECHANIC STREET SUITE 106 RED BANK, NJ 07701 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.14% |
| RYAN K GOLDBERG3 | 103-107 CHURCH ST 3 PHILADELPHIA, PA 19106 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $440 | — | $440 | 1.80% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES LLC | 1800 RTE 34 BLDG 4 WALL TOWNSHIP, NJ 07719 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $570 | $399 | $969 | 16.99% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $11 | $11 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $20K |
| DONALD C SAVOY INC GENERAL AGENT | Insurance brokerage commissions and fees Service code 53 | 25B HANOVER RD STE 220 FLORHAM PARK, NJ 07932 | $239 |
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 | 95 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 71 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $176K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $176K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $201K |
| Short-term disability(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $206K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $176K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $201K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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.