| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOLLINGER INC3 Filed as: BOLLINGER INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07891 | DELTA DENTAL OF NEW JERSEY, INC. | $30K | — | $30K | 3.59% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: WORLD INSURANCE ASSOCIATES, LLC | 656 SHREWSBURY AVE. STE 200 TINTON FALLS, NJ 07701 | DELTA DENTAL OF NEW JERSEY, INC. | $12K | — | $12K | 1.41% |
| BOLLINGER INC3 Filed as: BOLLINGER, INC. | 115 SOUTH JEFFERSON RD BLDG 200 WHIPPANY, NY 07981 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 2.38% |
| WORLD INS ASSOC LLC3 | 656 SHREWSBERRY AVE STE 200 TINTON FALLS, NJ 07701 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 906 W 2ND AVE STE 400 SPOKANE, WA 99201 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | — | $17K | 24.03% |
| BOLLINGER INC3 Filed as: BOLLINGER, INC. | 200 JEFFERSON PARK WHIPPANY, NJ 079814537 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 10.90% |
| DANIEL WARD RICHARDSON3 Filed as: DANIEL G ACETI | 7804 FAIRVIEW RD #266 CHARLOTTE, NC 282264998 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 9.44% |
| VANDBRIDGE LLC3 | 1185 AVENUE OF THE AMERICAS FL 32 NEW YORK, NY 100362603 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 3.65% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $685 | — | $685 | 15.00% |
| BOLLINGER INC3 Filed as: BOLLINGER, INC. | PO BOX 390 SHORT HILLS, NJ 070780390 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $759 | $6K | 1710.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 NONE | Non-monetary compensation; Float revenue; Participant communication; Direct payment from the plan; Named fiduciary; Claims processing; Contract Administrator; Other services Service code 12 | — | $658K |
| BOLLING, INC. NONE | Insurance agents and brokers Service code 22 | 200 JEFFERSON PARK WHIPPANY, NJ 07701 | $112K |
| THE PRUDENTIAL INSURANCE COMPANY OF EIN 22-1211670 NONE | Contract Administrator; Plan Administrator; Other fees Service code 13 | — | $71K |
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 | 1,073 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,096 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,183 | $656K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NEW JERSEY, INC. | 2,227 | $831K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,183 | $656K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,073 | $621K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,073 | $621K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,073 | $621K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,183 | $656K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,073 | $696K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,227 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.