| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK FRISCH3 | 80 CROSSWAYS PARK WEST WOODBURY, NY 11797 | BLUE CROSS & BLUE SHIELD OF MASSACHUSETTS, INC. | $29K | — | $29K | 1.25% |
| JEROME TEPPER3 | 50 BROADWAY HAWTHORNE, NY 10532 | BLUE CROSS & BLUE SHIELD OF MASSACHUSETTS, INC. | $10K | — | $10K | 0.42% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PRKWY STE 1950 ATLANTA, GA 303395946 | BLUE CROSS & BLUE SHIELD OF MASSACHUSETTS, INC. | $2K | — | $2K | 0.07% |
| JEROME TEPPER3 | 50 BROADWAY HAWTHORNE, NY 10532 | MONY LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 8.29% |
| INDIGO INSURANCE SERVICES3 | 101 HUNTINGTON AVE STE 1300 BOSTON, MA 021997611 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $11K | $11K | 7.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY ST STE 1950 ATLANTA, GA 30339 | MONY LIFE INSURANCE COMPANY OF AMERICA | $839 | — | $839 | 0.52% |
| GA SOLUTIONS LLC3 | 50 BROADWAY STE 2 HAWTHORNE, NY 105321253 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 4.60% |
| MARK FRISCH3 | 9735 NICKLE RIDGE CIRCLE NAPLES, FL 341204661 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 2.81% |
| MARK FRISCH3 Filed as: MARK N. FRISCH | 9735 NICKLE RIDGE CIRCLE NAPLES, FL 341204661 | VISION SERVICE PLAN | $772 | — | $772 | 3.96% |
| JEROME TEPPER3 | 50 BROADWAY HAWTHORNE, NY 105321245 | VISION SERVICE PLAN | $257 | — | $257 | 1.32% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PRKWY STE 1950 ATLANTA, GA 303395946 | VISION SERVICE PLAN | $59 | — | $59 | 0.30% |
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 | 240 | 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) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS & BLUE SHIELD OF MASSACHUSETTS, INC. | 368 | $2.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 518 | $140K |
| Vision | VISION SERVICE PLAN | 167 | $19K |
| Life insurance | MONY LIFE INSURANCE COMPANY OF AMERICA | 191 | $161K |
| Short-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 191 | $161K |
| Long-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 191 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 518 | — |
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.