| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MBL BENEFITS CONSULTING CORP3 | 323 WEST 39TH ST 11TH FL NEW YORK, NY 10018 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 0.39% |
| FNA INSURANCE SERVICES INC3 | 180 RIVER ROAD FLOOR 2 SUMMIT, NJ 07901 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $91K | $12K | $103K | 12.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 PLAN ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Named fiduciary; Non-monetary compensation; Float revenue Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $143K |
| CIGNA HEALTH & LIFE INSURANCE COM | Direct payment from the plan; Named fiduciary; Participant communication; Other services; Non-monetary compensation; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $0 |
| CIGNA HEALTH AND LIFE COM | Claims processing; Direct payment from the plan; Float revenue; Named fiduciary; Other services; Contract Administrator; Participant communication; Non-monetary compensation Service code 12 | — | $0 |
| FNA INSURANCE SERVICES INC EIN 46-4101382 GENERAL AGENT | Insurance agents and brokers Service code 22 | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | $0 |
| MBL BENEFITS CONSULTING CORP EIN 20-2930410 BROKER | Insurance agents and brokers Service code 22 | 323 W 39TH ST FL 11 NEW YORK, NY 10018 | $0 |
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 | 973 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 991 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,035 | $825K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,035 | $825K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,035 | $825K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,035 | $825K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,035 | $825K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,347 | $840K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,035 | $825K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,347 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.