| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SATS LLC3 | 77 SPRUCE STREET CEDARHURST, NY 11516 | AETNA LIFE INSURANCE COMPANY | $98K | — | $98K | 4.61% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | AETNA LIFE INSURANCE COMPANY | $4K | — | $4K | 0.18% |
| FNA INSURANCE SERVICES INC3 | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | AETNA LIFE INSURANCE COMPANY | $720 | — | $720 | 0.03% |
| GREATER METRO AGENCY INC3 Filed as: GREATER METRO AGENCY | 2003 JERICHO TRUNPIKE NEW HYDE PARK, NY 11040 | ANTHEM LIFE & DISABILITY INSURANCE CO | $6K | — | $6K | 5.01% |
| SATS LLC3 | 77 SPRUCE ST SUITE 203 CEDARHURST, NY 11516 | ANTHEM LIFE & DISABILITY INSURANCE CO | $4K | — | $4K | 3.69% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY RD SUITE 403 WOODBURY, NY 11797 | HARTFORD LIFE & ACCIDENT | $5K | $4K | $9K | 19.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TOTAL ADMINSTRATIVE SERVICES INC EIN 39-1561025 CLAIMS ADMIN/ RECORDKEEP | Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | PO BOX 14629 MADISON, WI 53708 | $34K |
| PREFERRED BENEFITS GROUP INC BROKER/INSURANCE AGENT | Insurance agents and brokers Service code 22 | FAIR LAWN AVE FAIR LAWN, NJ 07405 | $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 | 344 | 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) | 344 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 344 | $2.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 344 | $2.1M |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE CO | 344 | $118K |
| Short-term disability | ANTHEM LIFE & DISABILITY INSURANCE CO | 344 | $118K |
| Long-term disability | HARTFORD LIFE & ACCIDENT | 284 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 344 | — |
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."
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.