| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARC B. GOLDSTEIN3 | 108 PARK DRIVE MOUNT KISCO, NY 10549 | UNITEDHEALTHCARE INSURANCE COMPANY | $107K | — | $107K | 4.75% |
| ACRISURE LLC3 Filed as: ACRISURE PGM INSURANCE SRVCS, LLC | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $17K | $17K | 0.75% |
| GA SOLUTIONS LLC3 Filed as: GA SOLUTIONS, LLC | 65 MECHANIC STREET, SUITE 106 RED BANK, NJ 07701 | GUARDIAN LIFE INSURANCE | $17K | $5K | $22K | 11.43% |
| NEW YORK ROSBRUCH AND HARNIK3 | UNKNOWN WOODCLIFF LAKE, NJ 07677 | GUARDIAN LIFE INSURANCE | $4 | — | $4 | 0.00% |
| MARC GOLDSTEIN3 | 108 PARK DRIVE, UNIT 108 MOUNT KISCO, NY 10549 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 10.50% |
| GA SOLUTIONS LLC3 Filed as: GA SOLUTIONS, LLC | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 4.66% |
| BETH E FREDERICKSON3 Filed as: BETH FREDERICKSON | 19 DAVENPORT ROAD MONTVILLE, NJ 07045 | AFLAC | $1K | $118 | $1K | 12.04% |
| MICHAEL P ZILINSKI3 Filed as: MICHAEL ZILINSKI | 1633 WASHINGTON BOULEVARD APARTMENT 4E STAMFORD, CT 06902 | AFLAC | $380 | $17 | $397 | 4.09% |
| MICHAEL FORNARO & OTHERS3 | 271 US HIGHWAY 46, SUITE H119 FAIRFIELD, NJ 07004 | AFLAC | $221 | $4 | $225 | 2.32% |
| ANDREW HIGGINS3 | 22 TUTTLE AVENUE SPRING LAKE, NJ 07762 | AFLAC | $167 | $0 | $167 | 1.72% |
| ANTHONY G COLLINCINI3 Filed as: ANTHONY COLLINCINI | 165 WOOLLEY COURT OAKHURST, NJ 07755 | AFLAC | $102 | $0 | $102 | 1.05% |
| SAMANTHA CIOFFI3 | PO BOX 7131 OAKLAND, NJ 07436 | AFLAC | $62 | $10 | $72 | 0.74% |
| TYLER KNIGHT3 | 190 PEQUEST ROAD BELVIDERE, NJ 07823 | AFLAC | $69 | $0 | $69 | 0.71% |
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 | 40 | 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) | 40 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 310 | $2.2M |
| Dental | GUARDIAN LIFE INSURANCE | 91 | $192K |
| Vision | GUARDIAN LIFE INSURANCE | 91 | $192K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 52 | $53K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 52 | $53K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 52 | $53K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 310 | $2.2M |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 52 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 310 | — |
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.