| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SILBERSTEIN INSURANCE GROUP3 Filed as: SILBERSTEIN INSURANCE GROUP, LLC | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $2K | $6K | 20.72% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP | 3 PARKWAY NORTH SUITE 500 DEERFIELD, IL 60015 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $403 | $403 | 1.47% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $190 | $190 | 0.69% |
| SILBERSTEIN INSURANCE GROUP3 Filed as: SILBERSTEAIN INSURANCE GROUP LLC | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $1K | $3K | 12.10% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP | 3 PARKWAY NORTH SUITE 500 DEERFIELD, IL 60015 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $404 | $404 | 1.48% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $185 | $185 | 0.68% |
| SILBERSTEIN INSURANCE GROUP3 Filed as: SILBERSTEIN INSURANCE GROUP LLC | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $1K | $3K | 15.24% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP | 3 PARKWAY NORTH SUITE 500 DEERFIELD, IL 60015 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $304 | $304 | 1.48% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $140 | $140 | 0.68% |
| SILBERSTEIN INSURANCE GROUP3 Filed as: SILBERSTEIN INSURANCE GROUP LLC | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $368 | $154 | $522 | 21.28% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP | 3 PARKWAY NORTH SUITE 500 DEERFIELD, IL 60015 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $40 | $40 | 1.63% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $17 | $17 | 0.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE LOOMIS COMPANY EIN 23-2238132 TPA AND CLAIMS PROCESSOR | Claims processing; Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 850 N PARK ROAD PO BOX 7011 WYOMISSING, PA 19610 | $49K |
| SILBERSTEAIN INSURANCE GROUP LLC EIN 52-2132804 INSURANCE BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | $44K |
| CIGNA EIN 35-2029627 INSURANCE CARRIER | Insurance services Service code 23 | — | $22K |
| HINES ASSOCIATES EIN 36-3545085 CLAIMS CONSULTING | Consulting fees Service code 70 | 115 EAST HIGHLAND AVENUE ELGIN, IL 60120 | $7K |
| ZELIS CLAIMS INTEGRITY INC EIN 86-1040704 CLAIMS PROCESSOR | Claims processing Service code 12 | 2 CROSSROADS DRIVE BEDMINSTER, NJ 07921 | $7K |
| CIGNA EMBARC EIN 35-2029627 INSURANCE CARRIER | Insurance services Service code 23 | — | $2K |
| TELEDOC, INC EIN 04-3705970 HEALTH SERVICE PROVIDER | Other services Service code 49 | 2 MANHATTANVILLE ROAD PURCHASE, NY 10577 | $2K |
| EVOLUTIONS HEALTHCARE SYSTEMS EIN 59-3139483 INSURANCE CARRIER | Insurance services Service code 23 | 8406 MASSACHUSETTS AVE SUITE A-1 NEW PORT RICHEY, FL 34653 | $705 |
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 | 102 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $27K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $21K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $27K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 102 | $527K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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.