| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | PARK 80 WEST,PLAZA TWO, 250 PEHLE AVENUE, SUITE 400, SADDLE BROOK, NJ 07663 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $39K | $39K | 2.72% |
| DULEY BOLWAR & ASSOCIATES INC3 Filed as: DULEY-BOLWAR & ASSOC INC. | 14805 N 73RD ST SCOTTSDALE, AZ 85260 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $11K | $11K | 0.78% |
| GREATER METRO AGENCY INC3 | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | -$29 | -$29 | -0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | PARK 80 WEST,PLAZA TWO, 250 PEHLE AVENUE, SUITE 400, SADDLE BROOK, NJ 07663 | DELTA DENTAL OF NEW JERSEY | $7K | — | $7K | 5.00% |
| DULEY BOLWAR & ASSOCIATES INC3 Filed as: DULEY-BOLWAR & ASSOCIATES | 14805 N 73RD ST SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $141 | $4K | 12.66% |
| SEE ATTACHED3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 6.21% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | PARK 80 WEST, PLAZA TWO 250 PEHLE AVENUE, SUITE 400 SADDLE BROOK, NJ 07663 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $440 | $2K | 11.37% |
| FNA INSURANCE SERVICES INC3 | 180 RIVER ROAD FLOOR 2 SUMMIT, NJ 07901 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2 | — | $2 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | PARK 80 WEST,PLAZA TWO, 250 PEHLE AVENUE, SUITE 400, SADDLE BROOK, NJ 07663 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.37% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC. | 1000 WOODBURY ROAD 4TH FLOOR, SUITE 403 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $85 | $85 | 0.57% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | PARK 80 WEST,PLAZA TWO, 250 PEHLE AVENUE, SUITE 400, SADDLE BROOK, NJ 07663 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $365 | — | $365 | 11.99% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES INC. | 1000 WOODBURY ROAD 4TH FLOOR, SUITE 403 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $18 | $18 | 0.59% |
| DULEY BOLWAR & ASSOCIATES INC3 Filed as: DULEY-BOLWAR & ASSOCIATES | 14805 N 73RD ST SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $255 | — | $255 | 10.02% |
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 | 258 | 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) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 170 | $1.4M |
| Dental | DELTA DENTAL OF NEW JERSEY | 360 | $141K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 172 | $18K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 258 | $15K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 258 | $3K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 258 | $46K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 170 | $1.4M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 258 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 360 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.