| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DR STE 200 CAMDEN, NJ 08103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $18K | $18K | 2.02% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, INC. | 2 AQUARIUM DR STE 200 CAMDEN, NJ 081031000 | KAISER FOUNDATION HEALTH PLAN, INC. | $16K | — | $16K | 2.24% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 N CLARK ST FL 11 CHICAGO, IL 606543454 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 1.06% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP INC | 2 AQUARIUM DR STE 200 THE FERRY TERMINAL BUILDING CAMDEN, NJ 081031000 | METROPOLITAN LIFE INSURANCE COMPANY | — | $122 | $122 | 0.04% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, INC. | 2 AQUARIUM DR STE 200 CAMDEN, NJ 081031000 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | — | $4K | 1.91% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 N CLARK ST FL 11 CHICAGO, IL 606543454 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 1.31% |
| LONG TERM CARE SOLUTIONS, INC.3 Filed as: LONG TERM CARE SOLUTIONS INC | 14715 NE 95TH ST STE 200 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 10.86% |
| CORPORATE SYNERGIES GROUP LLC3 | 1212 6TH AVE NEW YORK, NY 10036 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 8.13% |
| VAN EPPS, JAMES, H3 | 10930 CRABAPPLE RD, STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $101 | $1K | 2.35% |
| BLOCK, CHARLES, D3 | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $101 | $1K | 2.35% |
| SMITH, THOMAS, CHRISTOPHER3 | PO BOX 40386 798 BERRY RD NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $149 | — | $149 | 0.28% |
| CORPORATE SYNERGIES GROUP LLC3 | 1212 6TH AVE NEW YORK, NY 10036 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 4.85% |
| BLOCK, CHARLES, D3 | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $550 | $50 | $600 | 2.01% |
| VAN EPPS, JAMES, H3 | 10930 CRABAPPLE RD, STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $550 | $50 | $600 | 2.01% |
| SMITH, THOMAS, CHRISTOPHER3 | PO BOX 40386 798 BERRY RD NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $445 | — | $445 | 1.49% |
| CORPORATE SYNERGIES GROUP LLC3 | 1212 6TH AVE NEW YORK, NY 10036 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $692 | $324 | $1K | 7.34% |
| CORPORATE SYNERGIES GROUP LLC3 | 1212 6TH AVE NEW YORK, NY 10036 | FIRST UNUM LIFE INSURANCE COMPANY | $78 | — | $78 | 29.89% |
| VAN EPPS, JAMES, H3 | 10930 CRABAPPLE RD, STE 206 ROSWELL, GA 30075 | FIRST UNUM LIFE INSURANCE COMPANY | $39 | $4 | $43 | 16.48% |
| BLOCK, CHARLES, D3 | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | FIRST UNUM LIFE INSURANCE COMPANY | $39 | $4 | $43 | 16.48% |
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 | 1,722 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,731 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 132 | $878K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,087 | $326K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 2,161 | $48K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,722 | $885K |
| Short-term disability(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,722 | $915K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,722 | $885K |
| Other(5 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,722 | $958K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,161 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.