| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| E BENEFIT SOLUTION INC3 Filed as: E BENEFIT SOLUTION, INC. | 21704 NORTHERN BOULEVARD BAYSIDE, NY 11361 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $36K | — | $36K | 1.03% |
| DONALD C SAVOY INC3 Filed as: DONALD C. SAVOY, INC. | 25B HANOVER ROAD, SUITE 220 FLORHAM PARK, NJ 07932 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $28K | — | $28K | 0.79% |
| DONALD C SAVOY INC3 Filed as: DONALD C. SAVOY, INC. | 25B HANOVER ROAD, SUITE 220 FLORHAM PARK, NJ 07932 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 7.94% |
| UNKNOWN3 | UNKNOWN PORT WASHINGTON, NY 11050 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 3.76% |
| E BENEFIT SOLUTION INC3 Filed as: E BENEFIT SOLUTION, INC. | 21704 NORTHERN BOULEVARD BAYSIDE, NY 11361 | METROPOLITAN LIFE INSURANCE COMPANY | $367 | — | $367 | 5.05% |
| DONALD C SAVOY INC3 Filed as: DONALD C. SAVOY, INC. | 25B HANOVER ROAD, SUITE 220 FLORHAM PARK, NJ 07932 | METROPOLITAN LIFE INSURANCE COMPANY | $220 | $110 | $330 | 4.54% |
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 | 258 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 572 | $3.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $139K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 233 | $7K |
| Prescription drug | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 572 | $3.5M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 233 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 572 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.