| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OMNI MANAGED HEALTH, INC.3 Filed as: OMNI MANAGED HEALTH INC | 3021 AVENUE J BROOKLYN, NY 11210 | EMBLEM HEALTH | $89K | — | $89K | 3.92% |
| OMNI MANAGED HEALTH, INC.3 Filed as: OMNI MANAGED HEALTH INC. | 3021 AVENUE J BROOKLYN, NY 11210 | EMPIRE HEALTHCHOICE HMO, INC. | $19K | — | $19K | 1.38% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN SVCS | 1133 WESTCHESTER AVENUE, SUITE S229 WHITE PLAINS, NY 10604 | EMPIRE HEALTHCHOICE HMO, INC. | $7K | $4K | $11K | 0.82% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL SVCS | 1133 WESTCHESTER AVENUE SUITE S229 WHITE PLAINS, NY 10604 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $5K | — | $5K | 4.00% |
| AHF GROUP BENEFITS LTD3 | 3023 AVENUE J BROOKLYN, NY 112103837 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $2K | — | $2K | 2.00% |
| ALEX HERSKOVICH3 | 3023 AVENUE J BROOKLYN, NY 112103837 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $2K | — | $2K | 2.00% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS (NJ) | 4851 LBJ FWY SUITE 100 DALLAS, TX 75244 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $0 | $5K | $5K | 3.97% |
| AHF GROUP BENEFITS LTD3 | 3023 AVENUE J BROOKLYN, NY 11210 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $2K | — | $2K | 1.99% |
| ALEX HERSKOVICH3 | 1213 EAST 31 STREET BROOKLYN, NY 11210 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $2K | — | $2K | 1.99% |
| GA SOLUTIONS LLC3 | 50 BROADWAY 2ND FL HAWTHORNE, NY 10532 | HARTFORD LIFE AND ACCIDENT | $11K | $6K | $16K | 14.00% |
| PROEFESSIONAL GROUP MARKETING3 | 50 BROADWAY HAWTHORNE, NY 10532 | HARTFORD LIFE AND ACCIDENT | -$10 | -$15 | -$25 | -0.02% |
| TOTALBEN LLC3 | 1374 E 28TH ST BROOKLYN, NY 11210 | SHELTERPOINT LIFE INSURANCE CO | $5K | — | $5K | 12.00% |
| TOTALBEN LLC3 | 1374 EAST 28TH ST BROOKLYN, NY 11210 | SHELTERPOINT LIFE INSURANCE CO | $350 | — | $350 | 12.02% |
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 | 282 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | EMBLEM HEALTH | 370 | $3.6M |
| Dental(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 201 | $239K |
| Vision(2 contracts) | SHELTERPOINT LIFE INSURANCE CO | 1,540 | $46K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 277 | $117K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 277 | $117K |
| Prescription drug(3 contracts, 2 carriers) | EMBLEM HEALTH | 370 | $3.6M |
| Other | HARTFORD LIFE AND ACCIDENT | 277 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,540 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.