| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| E BENEFIT SOLUTION INC3 | UNKNOWN PORT WASHINGTON, NY 11050 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $56K | $0 | $56K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: RISK PLACEMENT SERVICES, INC. | 200 CONNELL DRIVE, SUITE 1000 BERKELEY HEIGHTS, NJ 07922 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $9K | $9K | 8.78% |
| E BENEFIT SOLUTION INC3 | 217-04 NORTHERN BOULEVARD BAYSIDE, NY 11361 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $4K | $0 | $4K | 3.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | UNKNOWN RIVERSIDE, CA 92501 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.16% |
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 | 179 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 420 | $2.8M |
| Dental | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 140 | $106K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY | 165 | $21K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 420 | $2.8M |
| Other | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY | 165 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 420 | — |
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.