| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAFETZ AND ASSOCIATES, LLC3 | 609 NEW ROAD LINWOOD, NJ 08221 | HORIZON HEALTHCARE SERVICES, INC. | $55K | — | $55K | 2.87% |
| HAFETZ AND ASSOCIATES, LLC3 | 609 NEW ROAD LINWOOD, NJ 08221 | USABLE LIFE | $14K | — | $14K | 13.73% |
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | — | $7K | $7K | 6.53% |
| COMPLIANCE SERVICES AGENCY3 | UNKNOWN BARRINGTON, NJ 08007 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 8.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | UNKNOWN BARRINGTON, NJ 08007 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 6.88% |
| FORZA GROUP, LLC3 | 14 MARSHALL DRIVE EGG HARBOR TOWNSHIP, NJ 08234 | COMBINED INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 69.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203066 DALLAS, TX 75320 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $591 | — | $591 | 6.37% |
| COMPLIANCE SERVICES AGENCY3 | UNKNOWN BARRINGTON, NJ 08007 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $258 | — | $258 | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | UNKNOWN BARRINGTON, NJ 08007 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $192 | — | $192 | 5.95% |
| FORZA GROUP, LLC3 | 14 MARSHALL DRIVE EGG HARBOR TOWNSHIP, NJ 08234 | AFLAC | $887 | — | $887 | 38.22% |
| MICHAEL USIAK3 | 85 RIVER EDGE FARMS ROAD MADISON, CT 06443 | AFLAC | $24 | — | $24 | 1.03% |
| COMPLIANCE SERVICES AGENCY3 | UNKNOWN BARRINGTON, NJ 08007 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $225 | — | $225 | — |
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 | 193 | 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) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 161 | $2.0M |
| Dental(2 contracts, 2 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 161 | $2.0M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 4 | $56K |
| Life insurance(3 contracts, 3 carriers) | USABLE LIFE | 193 | $163K |
| Short-term disability(2 contracts, 2 carriers) | USABLE LIFE | 193 | $106K |
| Long-term disability | USABLE LIFE | 193 | $104K |
| Prescription drug(2 contracts, 2 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 161 | $1.9M |
| Other(5 contracts, 4 carriers) | USABLE LIFE | 193 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.