| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS FL 8 NEW YORK, NY 10036 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | -$5K | $3K | 3.96% |
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS FL 8 NEW YORK, NY 10036 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $5K | $0 | $5K | 15.00% |
| THE DBL CENTER LTD3 | 155 PINELAWN ROAD STE 120 SOUTH MELVILLE, NY 11747 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $0 | $3K | $3K | 8.01% |
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS FL 8 NEW YORK, NY 100368401 | VISION SERVICE PLAN | $2K | $0 | $2K | 10.02% |
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS FL 8 NEW YORK, NY 10036 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | $0 | $2K | 9.33% |
| THE DBL CENTER LTD3 | 155 PINELAWN ROAD STE 120 SOUTH MELVILLE, NY 11747 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $0 | $2K | $2K | 8.00% |
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS FL 8 NEW YORK, NY 10036 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | $0 | $2K | 10.50% |
| THE DBL CENTER LTD3 | 155 PINELAWN ROAD STE 120 SOUTH MELVILLE, NY 11747 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $0 | $1K | $1K | 8.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EAGLE HEALTH PLANS, LLC EIN 47-4795156 NONE | Contract Administrator; Claims processing Service code 12 | — | $108K |
| GARY WOOD ASSOCIATES, INC NONE | Other commissions; Insurance brokerage commissions and fees Service code 53 | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | $57K |
| COVENANT ADMINISTRATIVE SERVIES LLC NONE | Claims processing; Contract Administrator Service code 12 | 2810 PREMIERE PARKWAY STE 400 DULUTH, GA 30097 | $21K |
| WAGEWORKS EIN 94-3351864 NONE | Claims processing; Contract Administrator Service code 12 | — | $11K |
| HS TECHNOLOGY SOLUTIONS, INC. EIN 27-1818792 NONE | Claims processing; Other services Service code 12 | — | $10K |
| MULTIPLAN, INC EIN 13-3068979 NONE | Claims processing; Other services Service code 12 | — | $6K |
| HINES & ASSOCIATES EIN 36-3545085 NONE | Other commissions; Insurance brokerage commissions and fees Service code 53 | — | $4K |
| TELEDOC, INC. EIN 04-3705970 NONE | Contract Administrator; Claims processing Service code 12 | — | $753 |
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 | 159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PAN AMERICAN | 101 | $460K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 204 | $84K |
| Vision | VISION SERVICE PLAN | 90 | $25K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 160 | $16K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 159 | $23K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 96 | $36K |
| Stop-loss / reinsurancereinsurance | PAN AMERICAN | 101 | $460K |
| Other | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 160 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.