| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 4.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE, 3RD FLOOR NEW YORK, NY 10177 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $10K | 15.20% |
| MARILY GOLDFISCHER3 | 124 WEST SADDLE RIVER ROAD SADDLE RIVER, NJ 07458 | AFLAC | $3K | $23 | $4K | 8.02% |
| ZORN BENEFITS GROUP LLC3 Filed as: ZORN BENEFITS GROUP, LLC | 60 US HIGHWAY 46 FAIRFIELD, NJ 07004 | AFLAC | $3K | $15 | $3K | 7.62% |
| MJ INSURANCE3 Filed as: AARON B BERG AND VARIOUS AGENTS | 100 VALLEY ROAD, SUITE 101 MOUNT ARLINGTON, NJ 07856 | AFLAC | $1K | — | $1K | 2.76% |
| DANIEL TYLER ADAMSON3 Filed as: DANIEL T. ADAMSONQ | 2700 NORTH MAIN STREET, SUITE 620 SANTA ANA, CA 92705 | AFLAC | $1K | $6 | $1K | 2.74% |
| MATHEW G. BERGER3 | 1020 NORTH DELAWARE AVENUE 4TH FLOOR PHILADELPHIA, PA 19125 | AFLAC | $753 | $8 | $761 | 1.74% |
| CHRISTOPHER STROUD3 | 120 SMITHTOWN ROAD HACKETTSTOWN, NJ 07840 | AFLAC | $623 | — | $623 | 1.42% |
| MICHAEL A FORNARO3 Filed as: MICHAEL A. FORNARO | 271 US HIGHWAY 46 SUITE H119 FAIRFIELD, NJ 07004 | AFLAC | $435 | $8 | $443 | 1.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $160 | $160 | 1.25% |
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 | 217 | 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) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 264 | $2.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 264 | $2.2M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 133 | $65K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 217 | $152K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 33 | $57K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 217 | $87K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 264 | $2.2M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 623 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 623 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.