| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 600 SYLVAN AVE STE 301 ENGLEWOOD CLIFFS, NJ 07632 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | $33K | $50K | 3.79% |
| CHARLES LA MANTIA3 | 123 ORCHARD AVE HEIGHTS TOWN, NJ 08520 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | $33K | $50K | 3.79% |
| PROFESSIONAL GROUP MARKETING INC3 | 50 BROADWAY HAWTHORNE, NY 10532 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $26K | $26K | 2.00% |
| CHARLES LA MANTIA3 | 123 ORCHARD AVE HEIGHTS TOWN, NJ 08520 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | — | $5K | 3.63% |
| ACRISURE LLC3 | 600 SYLVAN AVE STE 301 ENGLEWOOD CLIFFS, NJ 07632 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | — | $5K | 3.63% |
| PROFESSIONAL GROUP MARKETING INC3 | 50 BROADWAY HAWTHORNE, NY 10532 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $5K | $5K | 3.53% |
| ACRISURE LLC3 | 600 SYLVAN AVE STE 301 ENGLEWOOD CLIFFS, NJ 07632 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | $450 | $3K | 8.21% |
| ACRISURE LLC3 | 16 W 36TH ST FL 11 NEW YORK, NY 10018 | MUTUAL OF OMAHA INSURANCE COMPANY | $843 | $1K | $2K | 6.03% |
| ACRISURE LLC3 | 600 SYLVAN AVE SUITE 301 ENGLEWOOD CLIFFS, NJ 07632 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $389 | $2K | 10.92% |
| DAILYFEATS INC.3 | 131 TREMONT STREET 3RD FLOOR BOSTON, MA 02111 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $603 | — | $603 | 3.00% |
| WAG NY INC3 | 250 CROSSWAYS PK DR WOODBURY, NY 11797 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19 | — | $19 | 0.09% |
| ACRISURE LLC3 | 600 SYLVAN AVE STE 301 ENGLEWOOD CLIFFS, NJ 07632 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | $215 | $2K | 11.59% |
| ACRISURE LLC3 | 16 W 36TH ST FL 11 NEW YORK, NY 10018 | MUTUAL OF OMAHA INSURANCE COMPANY | $698 | $589 | $1K | 7.68% |
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 | 187 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 220 | $1.3M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 177 | $155K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 177 | $155K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $20K |
| Short-term disability(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 178 | $55K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 178 | $37K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.