| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 261 MADISON AVENUE, 5TH FLOOR NEW YORK, NY 10016 | OXFORD HEALTH INSURANCE, INC. | $39K | $0 | $39K | 2.78% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, LLC | 5000 DEARBORN CIRCLE, SUITE 100 MOUNT LAUREL, NJ 08054 | OXFORD HEALTH INSURANCE, INC. | $21K | $0 | $21K | 1.50% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, LLC | 2 AQUARIUM DRIVE, SUITE 200 CAMDEN, NJ 08103 | AETNA LIFE INSURANCE COMPANY | $2K | $43 | $2K | 2.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 330 MADISON AVENUE, 7TH FLOOR NEW YORK, NY 10017 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 7.25% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, LLC | 2 AQUARIUM DRIVE, SUITE 200 CAMDEN, NJ 08103 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $264 | $2K | 4.58% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | FIRST UNUM LIFE INSURANCE COMPANY | $648 | $0 | $648 | 1.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 150 EAST 42ND STREET, 16TH FLOOR NEW YORK, NY 10017 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $210 | $210 | 0.42% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $676 | $0 | $676 | 5.35% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, LLC | 2 AQUARIUM DRIVE, SUITE 200 CAMDEN, NJ 08103 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $493 | $0 | $493 | 3.90% |
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 | 156 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OXFORD HEALTH INSURANCE, INC. | 222 | $1.4M |
| Dental | AETNA LIFE INSURANCE COMPANY | 234 | $107K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 100 | $13K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 156 | $50K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 156 | $50K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 156 | $50K |
| Prescription drug | OXFORD HEALTH INSURANCE, INC. | 222 | $1.4M |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 156 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.