| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PIERSON & SMITH, INC.3 Filed as: PIERSON & SMITH | A DIV OF FIRST NIAGARA RISK MGMT 40 RICHARDS AVE NORWALK, CT 06854 | AETNA | $35K | — | $35K | 3.06% |
| FIRST NIAGARA RISK MANAGEMENT3 Filed as: FIRST NIAGARA RISK MANAGEMENT, INC. | 40 RICHARDS AVENUE 4TH FLOOR NORWALK, CT 06854 | DELTA DENTAL OF NJ, INC. | $3K | — | $3K | 3.00% |
| FIRST NIAGARA RISK MANAGEMENT3 | 40 RICHARDS AVENUE 4TH FLOOR NORWALK, CT 06854 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $233 | $3K | 15.68% |
| PPI BENEFIT SOLUTIONS5 | 10 RESEARCH PARKWAY WALLINGFORD, CT 06492 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $865 | $865 | 5.00% |
| FIRST NIAGARA RISK MANAGEMENT3 | 40 RICHARDS AVENUE 4TH FLOOR NORWALK, CT 06854 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $173 | $2K | 12.33% |
| PPI BENEFIT SOLUTIONS5 | 10 RESEARCH PARKWAY WALLINGFORD, CT 06492 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $632 | $632 | 5.00% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA | 88 | $1.1M |
| Dental | DELTA DENTAL OF NJ, INC. | 93 | $91K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 119 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 119 | $17K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 119 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.