| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS INSURANCE3 Filed as: CROSS INSURANCE INC - CONNECTICUT | 2 CORPORATE DRIVE STE 335 SHELTON, CT 06484 | UNITEDHEALTHCARE INSURANCE COMPANY | $74K | — | $74K | 2.37% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE - NEW YORK INC | 1210 PLEASANTVILLE ROAD BRIARCLIFF MANOR, NY 10510 | UNITEDHEALTHCARE INSURANCE COMPANY | $36K | — | $36K | 1.14% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: BENEFITMALL NY - CENTERSTONE INS | 1133 WESTCHESTER AVENUE STE S-229 WEST HARRISON, NY 10604 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $18K | $18K | 0.57% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE - NEW YORK INC | 1210 PLEASANTVILLE ROAD BRIARCLIFF MANOR, NY 10510 | UNITEDHEALTHCARE INSURANCE COMPANY | $15K | — | $15K | 14.00% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: BENEFITMALL NY - CENTERSTONE INS | 1133 WESTCHESTER AVENUE STE S-229 WEST HARRISON, NY 10604 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 4.58% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE INC - CONNECTICUT | 2 CORPORATE DRIVE STE 335 SHELTON, CT 06484 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 1.17% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE - NEW YORK INC | 1210 PLEASANTVILLE ROAD BRIARCLIFF MANOR, NY 10510 | UNITEDHEALTHCARE INSURANCE COMPANY | $845 | — | $845 | 0.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTERFLEX PAYMENTS LLC EIN 27-2256926 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 2508 HIGHLANDER WAY CARROLLTON, TX 75006 | $4K |
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 | 295 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 295 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 106 | $3.1M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 189 | $88K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 189 | $88K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 135 | $105K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 135 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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.