| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONNER STRONG & BUCKELEW Filed as: CONNOR STRONG & BUCKELEW | 40 LAKE CENTER EXECUTIVE PARK 401 R MARLTON, NJ 08053 | HCC LIFE INSURANCE COMPANY | $70K | — | $70K | 15.00% |
| CONNER STRONG & BUCKELEW3 Filed as: CONNOR STRONG & BUCKELEW | 40 LAKE CENTER EXECUTIVE PARK 401 R MARLTON, NJ 08053 | RELIASTAR LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| I.E. SHAFFER & CO. EIN 22-1750854 NONE | Contract Administrator Service code 13 | 830 BEAR TAVERN ROAD PO BOX 1028 WEST TRENTON, NJ 08628 | $698K |
| HORIZON HEALTHCARE SERVICES, INC EIN 22-0999690 NONE | Contract Administrator Service code 13 | — | $628K |
| PRINCETON HEALTHCARE SYSTEM EAP EIN 21-0635009 NONE | Other services Service code 49 | 1000 HERRONTOWN ROAD, CLOCK BLDG PRINCETON, NJ 08540 | $64K |
| DAVID A. GERSON, CPA & ASSO. , PC EIN 22-3163246 NONE | Accounting (including auditing) Service code 10 | 201 WEST PASSAIC STREET ROCHELLE PARK, NJ 07662 | $32K |
| PRUDENTIAL RETIREMENT INS. COMPANY EIN 06-1050034 NONE | Investment advisory (plan) Service code 27 | — | $23K |
| ORANSKY, SCARAGGI, & BORG PC EIN 22-3522685 NONE | Legal Service code 29 | — | $20K |
| TERRENCE R. MOONEY, CPA EIN 22-2310315 NONE | Accounting (including auditing) Service code 10 | 247 NEW JERSEY AVENUE ABSECON, NJ 08201 | $19K |
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 | 1,815 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 561 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,376 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NJ,INC. | 1,943 | $1.4M |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 0 | $304K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 2,394 | $469K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 0 | $304K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,394 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.