| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NICHOLAS H. LAMOTTE3 Filed as: NICHOLAS LAMOTTE | 795 EAST LANCASTER AVENUE SUITE 210 VILLANOVA, PA 19085 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | $30K | $39K | 2.39% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $1K | $15K | $16K | 0.98% |
| PENTRA LLC3 | 795 EAST LANCASTER AVENUE SUITE 210 VILLANOVA, PA 19085 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $4K | $4K | 0.27% |
| GORDON W ST JOHN3 Filed as: GORDON W. ST. JOHN | 795 EAST LANCASTER AVENUE SUITE 210 VILLANOVA, PA 19085 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 1.92% |
| USI INSURANCE SERVICES LLC3 | 201 ALHAMBRA CIRCLE, SUITE 1205 CORAL GABLES, FL 33134 | KAISER FOUNDATION HEALTH PLAN INC | $2K | $0 | $2K | 0.69% |
| GREG LAU3 | PO BOX 508 KULA, HI 96790 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $2K | $0 | $2K | 2.03% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $541 | $0 | $541 | 0.71% |
| PENTRA LLC3 | 795 EAST LANCASTER AVENUE SUITE 210 VILLANOVA, PA 19085 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $0 | $6K | 9.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 2.87% |
| PENTRA LLC3 | 795 EAST LANCASTER AVENUE SUITE 210 VILLANOVA, PA 19085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $708 | $6K | 17.45% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 4.56% |
| PENTRA LLC3 | 795 EAST LANCASTER AVENUE SUITE 210 VILLANOVA, PA 19085 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 22.60% |
| RONALD M KLEIMAN3 Filed as: RONALD M. KLEIMAN | 4522 RFD LONG GROVE, IL 60047 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $479 | $0 | $479 | 1.79% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | 897 12TH STREET HAMMONTON, NJ 08037 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $284 | $0 | $284 | 1.06% |
| USI INSURANCE SERVICES LLC3 | 201 ALHAMBRA CIRCLE, SUITE 1205 CORAL GABLES, FL 33134 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $237 | $0 | $237 | 0.89% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK, SUITE A BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $182 | $182 | 0.68% |
| PENTRA LLC3 | 795 EAST LANCASTER AVENUE SUITE 210 VILLANOVA, PA 19085 | TRANSAMERICA LIFE INSURANCE COMPANY | $15K | $0 | $15K | 57.40% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 5TH FLOOR NEW YORK, NY 10016 | TRANSAMERICA LIFE INSURANCE COMPANY | $287 | $0 | $287 | 1.09% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | 897 12TH STREET HAMMONTON, NJ 08037 | TRANSAMERICA LIFE INSURANCE COMPANY | $138 | $0 | $138 | 0.52% |
| RONALD M KLEIMAN3 Filed as: RONALD M. KLEIMAN | 4522 RFD LONG GROVE, IL 60047 | TRANSAMERICA LIFE INSURANCE COMPANY | $55 | $0 | $55 | 0.21% |
| USI INSURANCE SERVICES LLC3 | 2400 EAST COMMERCIAL BOULEVARD SUITE 600 FORT LAUDERDALE, FL 33308 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $638 | $0 | $638 | 3.81% |
| PENTRA LLC3 | 795 EAST LANCASTER AVENUE SUITE 210 VILLANOVA, PA 19085 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $568 | $0 | $568 | 3.39% |
| BENEFITVISION3 Filed as: BENEFITVISION INC. | 99 WOOD AVENUE, SUITE 501 ISELIN, NJ 08830 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $568 | $0 | $568 | 3.39% |
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 | 4,062 | 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) | 4,062 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 251 | $2.0M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 251 | $2.0M |
| Vision(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 251 | $2.0M |
| Life insurance(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 4,062 | $469K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,062 | $96K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,062 | $70K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 251 | $2.0M |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 4,062 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,062 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.