| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1000 WOODBURY ROAD WOODBURY, NY 11797 | EMPIRE HEALTHCHOICE ASSUR., INC | $90K | $0 | $90K | 2.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120PEWAUKEE RD SUITE 202 WAUKESHA, WI 53188 | EMPIRE HEALTHCHOICE ASSUR., INC | $36K | $16K | $52K | 1.50% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | EMPIRE HEALTHCHOICE ASSUR., INC | $0 | $52K | $52K | 1.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | EMPIRE HEALTHCHOICE ASSUR., INC | $0 | $5K | $5K | 0.14% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: FNA INSRUANCE SERVICES INC | 180 RIVER ROAD FLOOR 2 SUMMIT, NJ 07901 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | $0 | $14K | 12.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 3390 INIVERSITY AVE, SUITE 300 RIVERSIDE, CA 92501 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 4.99% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN ASSOCIATES | 1060 BROADWAY SUITE 400 ALBANY, NY 12204 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 1.86% |
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 | 319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSUR., INC | 219 | $3.5M |
| Dental | EMPIRE HEALTHCHOICE ASSUR., INC | 219 | $3.5M |
| Vision | EMPIRE HEALTHCHOICE ASSUR., INC | 219 | $3.5M |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 389 | $116K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 389 | $116K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 389 | $116K |
| Other(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSUR., INC | 389 | $3.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 389 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.