| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENNIE INSURANCE, LLC3 Filed as: BENNIE INSURANCE LLC | 700 CANAL ST STE 1 STAMFORD, CT 06902 | ANTHEM BLUE CROSS | $97K | — | $97K | 2.74% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD HAUPPAUGE, NY 11788 | ANTHEM BLUE CROSS | — | $30K | $30K | 0.86% |
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DRIVE SUITE 200 CAMDEN, NJ 08103 | ANTHEM BLUE CROSS | $20K | — | $20K | 0.55% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BOULEVARD 2ND FLOOR HAUPPAUGE, NY 11788 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 6.97% |
| CORPORATE SYNERGIES GROUP LLC3 | FERRY TERMINAL BUILDING 2 AQUARIUM DRIVE CAMDEN, NJ 08103 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $9K | $15K | 4.31% |
| BENNIE INSURANCE, LLC3 | 700 CANAL ST STAMFORD, CT 06902 | KAISER FOUNDATION HEALTH PLAN, INC. | $615 | — | $615 | 3.23% |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 371 | $3.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $353K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $353K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $353K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $353K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $353K |
| Prescription drug | ANTHEM BLUE CROSS | 371 | $3.5M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $353K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 371 | — |
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.