| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMERSON REID LLC3 Filed as: EMERSON REID AND COMPANY, INC. | 669 RIVER DRIVE, CENTER II SUITE 305 ELMWOOD PARK, NJ 07407 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $0 | $4K | $4K | 4.84% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $4K | $0 | $4K | 4.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BOULEVARD, SUITE 400 WOODBURY, NY 11797 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $139 | $0 | $139 | 0.16% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $4K | $0 | $4K | 8.03% |
| EMERSON REID LLC3 Filed as: EMERSON REID AND COMPANY, INC. | 669 RIVER DRIVE, CENTER II SUITE 305 ELMWOOD PARK, NJ 07407 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $0 | $3K | $3K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BOULEVARD, SUITE 400 WOODBURY, NY 11797 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $417 | $0 | $417 | 0.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 1393 VETERANS MEMORIAL HIGHWAY HAUPPAUGE, NY 11788 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 8.27% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF NEW YORK | 448 | $203K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 278 | $22K |
| Life insurance | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 100 | $87K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 100 | $51K |
| Other | NATIONAL EAP | 371 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 448 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.