| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DR STE 200 CAMDEN, NJ 081031000 | UNITEDHEALTHCARE INSURANCE COMPANY | $84K | $210K | $294K | 3.22% |
| CORPORATE SYNERGIES GROUP LLC3 | ORLANDO LOCATION 2 AQUARIUM DR STE 200 CAMDEN, NJ 08103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $58K | — | $58K | 9.33% |
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DR STE 200 CAMDEN, NJ 08103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $25K | $16K | $42K | 6.75% |
| THOMAS BURROUGHS3 | 211 BUCHANAN CIRCLE HENDERSONVILLE, TN 37075 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | — | $263 | $263 | 0.12% |
| THOMAS WILLIAMSON3 Filed as: THOMAS DUNN | 211 BUCHANAN CIRCLE HENDERESONVILLE, TN 37075 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | — | $263 | $263 | 0.12% |
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 | 1,120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 2,417 | $9.3M |
| Dental(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 2,417 | $9.3M |
| Vision(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 2,417 | $9.3M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 978 | $618K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 978 | $618K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 978 | $618K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 2,417 | $9.1M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 978 | $618K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,417 | — |
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.