| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFITS PROGRAMS3 | 897 12TH STREET HAMMONTON, NJ 08037 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $120 | $3K | 8.66% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS OF ARIZONA | 2800 N CENTRAL AVE SUITE 1100 PHOENIX, AZ 85004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $367 | — | $367 | 1.18% |
| CUSTOM BENEFITS PROGRAMS3 | 897 12TH STREET HAMMONTON, NJ 08037 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $87 | $2K | 8.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS OF ARIZONA | 2800 N CENTRAL AVE SUITE 1100 PHOENIX, AZ 85004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $284 | — | $284 | 1.14% |
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFIT PROGRAMA | 897 12TH STREET STE 300 HAMMONTON, NJ 08037 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $47 | $1K | 8.92% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS OF ARIZONA | 2800 N CENTRAL AVE SUITE 1100 PHOENIX, AZ 85004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $187 | — | $187 | 1.18% |
| CASSANDRA GREEN4 Filed as: CASSANDRA PRINKE | 25825 N MOON BLOSSUM LN PHOENIX, AZ 85083 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $187 | — | $187 | 6.06% |
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 | 512 | 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) | 512 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 389 | $271K |
| Vision | EYEMED VISION CARE | 664 | $53K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 512 | $299K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 512 | $60K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 512 | $99K |
| Other(5 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 267 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 664 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.