| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DKG INSURANCE & FINANCIAL SERVICES3 | 1133 WESTCHESTER AVE, SUITE S229 WHITE PLAINS, NY 10604 | EMBLEM HEALTH COMPANY | $272K | — | $272K | 2.30% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL SVCS | 12404 PARK CENTRAL DR, SUITE 400S DALLAS, TX 75251 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $4K | $6K | 1.18% |
| BENEFIT MALL3 | 1133 WESTCHESTER AVE WHITE PLAINS, NY 10604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $21K | $9K | $30K | 14.22% |
| BENEFIT MALL3 | 1133 WESTCHESTER AVE WHITE PLAINS, NY 10604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $19K | $8K | $27K | 14.28% |
| BENEFIT MALL3 | 1133 WESTCHESTER AVE WHITE PLAINS, NY 10604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $16K | $7K | $23K | 14.23% |
| EDWARD P LEVINS3 Filed as: EDWARD LEVINS | 34 IRVING WALK BREEZY POINT, NY 11697 | H M LIFE INSURANCE COMPANY | $3K | — | $3K | 6.00% |
| CORPORATE HEALTH SERVICES3 Filed as: CORPORATE HEALTH BENEFITS | — | H M LIFE INSURANCE COMPANY | $2K | — | $2K | 4.00% |
| EDWARD P LEVINS3 Filed as: EDWARD LEVINS | 34 IRVING WALK BREEZY POINT, NY 11697 | EYE MED | $670 | — | $670 | 2.72% |
| CORPORATE HEALTH INNOVATIONS3 | 120 WHITE PINE CT MILFORD, PA 18337 | EYE MED | — | — | $0 | 0.00% |
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 | 1,349 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,349 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMBLEM HEALTH COMPANY | 898 | $11.9M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 956 | $533K |
| Vision(2 contracts, 2 carriers) | H M LIFE INSURANCE COMPANY | 1,003 | $78K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,349 | $187K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,349 | $211K |
| Prescription drug | EMBLEM HEALTH COMPANY | 898 | $11.9M |
| Other(2 contracts, 2 carriers) | EMBLEM HEALTH COMPANY | 1,349 | $12.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,349 | — |
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.