| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONALD C SAVOY INC3 | 25B HANOVER ROAD SUITE 220 FLORHAM PARK, NJ 07932 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $10K | $10K | 3.67% |
| LEAGUE CORP3 | 515 NORTH STATE STREET 14TH FLOOR CHICAGO, IL 60654 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $7K | — | $7K | 2.49% |
| SOLOMONS, DAVID M3 Filed as: SOLOMONS, DAVID | 140 BROADWAY 46TH FLOOR NEW YORK, NY 10005 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | — | $5K | 1.69% |
| GFI INSURANCE BROKERAGE3 Filed as: GFI INSURANCE BROKERAGE INC. | PO BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 0.55% |
| LEAGUE CORP3 | 515 NORTH STATE STREET 8TH FLOOR CHICAGO, IL 60654 | FIRST UNUM LIFE INSURANCE COMPANY | $8K | — | $8K | 4.48% |
| SOLOMONS, DAVID M3 | 140 BROADWAY 46TH FLOOR NEW YORK, NY 10005 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | — | $5K | 2.70% |
| LEAGUE CORP3 | 515 NORTH STATE STREET 8TH FLOOR CHICAGO, IL 60654 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 8.37% |
| SOLOMONS, DAVID M3 | 140 BROADWAY 46TH FLOOR NEW YORK, NY 10005 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 7.92% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 158 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 158 | $284K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 158 | $284K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 160 | $184K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 160 | $168K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 160 | $168K |
| Other(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 160 | $184K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.