| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 150 EAST 42ND STREET, 16TH FLOOR NEW YORK, NY 10017 | OXFORD HEALTH PLANS NY, INC. | $140K | — | $140K | 4.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 330 MADISON AVENUE, 7TH FLOOR NEW YORK, NY 10017 | AETNA LIFE INSURANCE COMPANY | $12K | — | $12K | 3.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | UNKNOWN UNIONDALE, NY 11573 | AETNA LIFE INSURANCE COMPANY | — | $67 | $67 | 0.02% |
| WINSTON FINANCIAL SERVICES3 | 1705 BAY AVENUE POINT PLEASANT, NJ 08742 | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | $5K | — | $5K | 6.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 330 MADISON AVENUE, 7TH FLOOR NEW YORK, NY 10017 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 5.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 10 SOUTH WACKER DRIVE, 17TH FLOOR CHICAGO, IL 60606 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 2.22% |
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 | 208 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OXFORD HEALTH PLANS NY, INC. | 475 | $3.5M |
| Dental | AETNA LIFE INSURANCE COMPANY | 509 | $303K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 228 | $49K |
| Long-term disability | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | 186 | $77K |
| Prescription drug | OXFORD HEALTH PLANS NY, INC. | 475 | $3.5M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 228 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 509 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.