| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | P.O. BOX 101162 PASADENA, CA 91189 | THE HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 0.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 18TH FLOOR CONCOURSE CORPORATE CENTER 5 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.76% |
| LOUIS R FAIOLA3 Filed as: LOUIS J. PANTOLONE | P.O. BOX 116 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.76% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAM, INC. | 897 12TH ST. HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.70% |
| JO A. PANTOLONE3 | 897 12TH ST. HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 18TH FLOOR CONCOURSE CORPORATE CENTER 5 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 2.35% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAM, INC. | 897 12TH ST. HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.14% |
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 | 1,292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 1,856 | $1.4M |
| Long-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,856 | $1.3M |
| Other(6 contracts, 6 carriers) | AETNA LIFE INSURANCE CO. | 1,856 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,856 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.