| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA, INC. | 1855 STATE ROAD, SUITE 434 LONGWOOD, FL 32750 | UNITED HEALTHCARE INSURANCE COMPANY | — | $100K | $100K | 5.02% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE NEW JERSEY | 354 EISENHOWER PARKWAY, SUITE 2850 LIVINGSTON, NJ 07039 | UNITED HEALTHCARE INSURANCE COMPANY | $88 | — | $88 | 0.00% |
| CAPACITY BENEFITS AND FIN3 Filed as: CAPACITY BENEFITS AND FIN. SERVICES | 1 INTERNATIONAL BOULEVARD MAHWAH, NJ 07495 | UNITED HEALTHCARE INSURANCE COMPANY | — | $18 | $18 | 0.00% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434, SUITE 250 LONGWOOD, FL 32750 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | $4K | $20K | 12.60% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 737 MAIN STREET, SUITE 200 BUFFALO, NY 14203 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 5.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA, INC. | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $2K | $9K | 13.52% |
| LIAZON BENEFITS INC5 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| CAPACITY BENEFITS AND FIN3 Filed as: CAPACITY BENEFITS AND FIN. SERVICES | ONE INTERNATIONAL BOULEVARD SUITE 340 MAHWAH, NJ 07495 | METROPOLITAN LIFE INSURANCE COMPANY | — | $127 | $127 | 0.18% |
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 | 229 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 437 | $2.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 183 | $158K |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 183 | $227K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 114 | $69K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 114 | $69K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 114 | $69K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 437 | $2.0M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 114 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 437 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.