| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MY BENEFIT ADVISOR LLC3 | 669 RIVER DRIVE CENTER II SUITE 305 ELMWOOD PARK, NJ 07407 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $31K | $0 | $31K | 3.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $21K | $0 | $21K | 2.54% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST VEVA 16, SUITE 320 BLUE BELL, PA 19422 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $13K | $13K | 1.56% |
| MY BENEFIT ADVISOR LLC3 | 669 RIVER DRIVE RIVER DRIVE CENTER II ELMWOOD PARK, NJ 07407 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $6K | $17K | 9.04% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST, SUTIE 320 BLUE BELL, PA 19422 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $11K | $11K | 5.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 5600 NEW KING DRIVE, SUITE 210 TROY, MI 48098 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $1K | $5K | 2.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.74% |
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 | 106 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $806K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 270 | $189K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 270 | $189K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 270 | $189K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 270 | $189K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 270 | $189K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $806K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 270 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.