| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | AETNA LIFE INSURANCE COMPANY | $19K | $0 | $19K | 12.00% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DRIVE DALLAS, TX 75251 | AETNA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 5.00% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | $4K | $0 | $4K | 11.07% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | $1K | $0 | $1K | 10.72% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | $708 | $0 | $708 | 12.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Claims processing; Contract Administrator Service code 12 | — | $220K |
| CENTERSTONE INS & FIN SERV (NY) NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 1133 WESTCHESTER AVE. SUITE 229 WHIE PLAINS, NY 10602 | $0 |
| FOUNDATION RISK PARTNERS CORP NONE | Insurance agents and brokers; Insurance services Service code 22 | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | $0 |
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 | 225 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE CO | 306 | $1.4M |
| Dental | AETNA LIFE INSURANCE COMPANY | 390 | $154K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE CO | 306 | $1.4M |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 225 | $12K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 225 | $38K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE CO | 306 | $1.4M |
| Other | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 225 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.