| 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 | $41K | — | $41K | 2.79% |
| D0 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | — | $0 | 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 | $5K | — | $5K | 3.76% |
| DULEY BOLWAR & ASSOCIATES INC3 Filed as: DULEY-BOLWAR & ASSOCIATES | 14805 N 73RD ST SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 9.56% |
| 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 | 9.40% |
| 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 | — | $262 | $262 | 1.26% |
| 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 | $1K | $1K | $2K | 13.64% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $434 | — | $434 | 2.44% |
| SEE ATTACHED3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $811 | — | $811 | 7.68% |
| 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 | $518 | — | $518 | 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 | — | $52 | $52 | 1.20% |
| DULEY BOLWAR & ASSOCIATES INC3 Filed as: DULEY-BOLWAR & ASSOCIATES | 14805 N 73RD ST SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $293 | — | $293 | 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 | 263 | 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) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 167 | $1.5M |
| Dental | DELTA DENTAL OF NEW JERSEY | 343 | $142K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 161 | $18K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 263 | $21K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 263 | $3K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 263 | $62K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 167 | $1.5M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 263 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 343 | — |
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.