| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 1285 DRUMMERS LN WAYNE, PA 19087 | DELTA DENTAL OF NEW JERSEY, INC. | $8K | — | $8K | 1.18% |
| ALLIANT INSURANCE SERVICES, INC.3 | 6550 ROCK SPRING DR. STE 610 BETHESDA, MD 20817 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 2.49% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET 6TH FL SAN DIEGO, CA 92101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 0.79% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1501 REEDSDALE ST. STE 3005 PITTSBURGH, PA 15233 | EYEMED | $13K | — | $13K | 9.90% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST FL 6 SAN DIEGO, CA 921018156 | METROPOLITAN LIFE INSURANCE COMPANY | $23K | $54 | $23K | 33.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 906 W 2ND AVE STE 400 SPOKANE, WA 99201 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 2.84% |
| DANIEL WARD RICHARDSON3 Filed as: DANIEL G ACETI | 7804 FAIRVIEW RD #266 CHARLOTTE, NC 282264998 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 2.81% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: WORLD INSURANCE ASSOCIATES, LLC | 656 SHREWSBURY AVE STE 200 TINTON FALLS, NJ 077014964 | METROPOLITAN LIFE INSURANCE COMPANY | $876 | — | $876 | 1.25% |
| BOLLINGER INC3 Filed as: BOLLINGER, INC. | 200 JEFFERSON PARK WHIPPANY, NJ 079814537 | METROPOLITAN LIFE INSURANCE COMPANY | $797 | — | $797 | 1.14% |
| VANDBRIDGE LLC3 | PO BOX 734174 CHICAGO, IL 606734174 | METROPOLITAN LIFE INSURANCE COMPANY | $553 | — | $553 | 0.79% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 1166 AVENUE OF THE AMERICAS 22ND FL NEW YORK, NY 10036 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $627 | — | $627 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 NONE | Named fiduciary; Contract Administrator; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Float revenue; Participant communication Service code 12 | — | $713K |
| THE PRUDENTIAL INSURANCE COMPANY OF EIN 22-1211670 NONE | Other fees; Plan Administrator; Contract Administrator Service code 13 | — | $88K |
| ALLIANT INSURANCE SERVICES, INC. NONE | Insurance agents and brokers Service code 22 | 701 B ST. 6TH FL SAN DIEGO, CA 92101 | $81K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing; Participant communication Service code 12 | — | $19K |
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 | 1,136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 68 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 2,145 | $710K |
| Vision | EYEMED | 1,850 | $128K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,136 | $697K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,136 | $697K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,136 | $697K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,205 | $967K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,136 | $772K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,205 | — |
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.