| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DR SUITE 200 CAMDEN, NJ 08103 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $35K | $35K | 3.38% |
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DRIVE STE 200 CAMDEN, NJ 08103 | HARTFORD LIFE AND ACCIDENT | $12K | — | $12K | 10.00% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS, CORP | 400 N PONCE DE LEON BLVD. SAINT AUGUSTINE, FL 32084 | HARTFORD LIFE AND ACCIDENT | — | $7K | $7K | 5.89% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, LLC | 2 AQUARIUM DRIVE SUITE 200 CAMDEN, NJ 08103 | UNITED CONCORDIA INSURANCE COMPANY | $3K | $615 | $4K | 5.38% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES - MT. LAUREL, | NJ PO BOX 654118 DALLAS, TX 75265 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $305 | — | $305 | 4.47% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 106 | $1.0M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 247 | $76K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 227 | $7K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 157 | $121K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 157 | $121K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 157 | $121K |
| Other | HARTFORD LIFE AND ACCIDENT | 157 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 247 | — |
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."
Final-filing indicator set. Plan is winding down; don't waste sales effort here.