| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAMBRIDGE LIFE BROKERAGE LLC3 | 1 COPPERFIELD WAY MORRISTOWN, NJ 07960 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $25K | — | $25K | 3.60% |
| DONALD C SAVOY INC3 Filed as: DONALD C. SAVOY, INC. | ROUND TABLE STUDIOS, SUITE 1000 200 CONNELL DRIVE BERKELEY HEIGHTS, NJ 14747 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $21K | $21K | 3.04% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PARKWAY VEVA 16, SUITE 320 BLUE BELL, PA 19422 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $4K | $4K | 0.63% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1305 WALT WHITMAN ROAD SUITE 310 MELVILLE, NY 11747 | DELTA DENTAL OF NEW JERSEY, INC. | $4K | — | $4K | 5.00% |
| CAMBRIDGE LIFE BROKERAGE LLC3 | 875 AVENUE OF THE AMERICAS SUITE 801 NEW YORK, NY 10001 | DELTA DENTAL OF NEW JERSEY, INC. | $4K | — | $4K | 4.34% |
| CAMBRIDGE LIFE BROKERAGE LLC3 | 65 MADISON AVE SUITE 200 MORRISTOWN, NJ 07960 | SUN LIFE ASSURANCE OF CANADA | $9K | — | $9K | 15.83% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PARKWAY VEVA 16, SUITE 320 BLUE BELL, PA 19422 | SUN LIFE ASSURANCE OF CANADA | — | $3K | $3K | 4.95% |
| CAMBRIDGE LIFE BROKERAGE LLC3 | 1 COPPERFIELD WAY MORRISTOWN, NJ 07960 | EYEMED VISION CARE | $841 | — | $841 | 9.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 SERVICE PROVIDER | Contract Administrator; Named fiduciary; Direct payment from the plan; Non-monetary compensation; Claims processing; Other services; Participant communication Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $4K |
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 | 115 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 88 | $697K |
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 99 | $88K |
| Vision | EYEMED VISION CARE | 77 | $9K |
| Life insurance | SUN LIFE ASSURANCE OF CANADA | 115 | $59K |
| Long-term disability | SUN LIFE ASSURANCE OF CANADA | 115 | $59K |
| Other | SUN LIFE ASSURANCE OF CANADA | 115 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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.