| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAFETZ AND ASSOCIATES, LLC3 | 609 NEW ROAD LINWOOD, NJ 08221 | HORIZON HEALTHCARE SERVICES, INC. | $34K | $0 | $34K | 1.62% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNSELMAN MICHAELS DOWNES | 555 FAIRMONT AVENUE BALTIMORE, MD 21286 | HORIZON HEALTHCARE SERVICES, INC. | $27K | $0 | $27K | 1.26% |
| HAFETZ AND ASSOCIATES, LLC3 | 609 NEW ROAD LINWOOD, NJ 08221 | USABLE LIFE | $7K | $3K | $11K | 9.60% |
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | $0 | $8K | $8K | 7.31% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNSELMAN MICHAELS DOWNES | 555 FAIRMONT AVENUE BALTIMORE, MD 21286 | USABLE LIFE | $6K | $0 | $6K | 5.30% |
| COMPLIANCE SERVICES AGENCY3 | 500 PELHAM DRIVE GALLOWAY, NJ 08205 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | $0 | $7K | 8.06% |
| COMPLIANCE SERVICES AGENCY3 | 500 PELHAM DRIVE GALLOWAY, NJ 08205 | KANAWHA INSURANCE COMPANY | $4K | $0 | $4K | 10.96% |
| FORZA GROUP, LLC3 Filed as: FORZA GROUP LLC | 1616 PACIFIC AVENUE ATLANTIC CITY, NJ 08401 | KANAWHA INSURANCE COMPANY | $799 | $0 | $799 | 2.09% |
| MARC A GROVE3 Filed as: MARC CARPENTER | 121 BALFOUR AVENUE LINWOOD, NJ 08221 | KANAWHA INSURANCE COMPANY | $143 | $0 | $143 | 0.37% |
| HAFETZ AND ASSOCIATES, LLC3 | 609 NEW ROAD LINWOOD, NJ 08221 | HEALTHCARE DENTAL, INC. | $395 | $0 | $395 | 2.52% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNSELMAN MICHAELS DOWNES | 555 FAIRMONT AVENUE BALTIMORE, MD 21286 | HEALTHCARE DENTAL, INC. | $256 | $0 | $256 | 1.64% |
| COMPLIANCE SERVICES AGENCY3 | 500 PELHAM DRIVE GALLOWAY, NJ 08205 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $495 | $0 | $495 | 8.01% |
| FORZA GROUP, LLC3 Filed as: FORZA GROUP LLC | 1616 PACIFIC AVENUE ATLANTIC CITY, NJ 08401 | COMBINED INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 67.98% |
| FORZA GROUP, LLC3 Filed as: FORZA GROUP LLC | 14 MARSHALL DRIVE EGG HARBOR TOWNSHIP, NJ 08234 | AFLAC | $227 | $0 | $227 | 8.97% |
| MICHAEL USIAK3 | 85 RIVER EDGE FARMS ROAD MADISON, CT 06443 | AFLAC | $6 | $9 | $15 | 0.59% |
| COMPLIANCE SERVICES AGENCY3 | 500 PELHAM DRIVE GALLOWAY, NJ 08205 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $225 | $0 | $225 | 10.00% |
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 | 239 | 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) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 193 | $2.2M |
| Dental(3 contracts, 3 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 193 | $2.2M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 4 | $90K |
| Life insurance(3 contracts, 3 carriers) | USABLE LIFE | 232 | $157K |
| Short-term disability(2 contracts, 2 carriers) | USABLE LIFE | 232 | $115K |
| Long-term disability | USABLE LIFE | 232 | $113K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 193 | $2.1M |
| Other(5 contracts, 5 carriers) | USABLE LIFE | 239 | $163K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.