| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| E BENEFIT SOLUTION INC3 | 222 BRIDGE PLAZA SOUTH 510 FORT LEE, NJ 07024 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $45K | — | $45K | 1.82% |
| DONALD C SAVOY INC3 | 25B HANOVER ROAD #B SUITE 220 FLORHAM PARK, NJ 07932 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | — | $41K | $41K | 1.66% |
| CHUN-HA INSURANCE SERVICES, INC.3 | 9122 GARDEN GROVE BLVD GARDEN GROVE, CA 92844 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $12K | — | $12K | 10.00% |
| CHUN-HA INSURANCE SERVICES, INC.3 | 9122 GARDEN GROVE BLVD GARDEN GROVE, CA 92844 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CHUN-HA INSURANCE SERVICES, INC.3 | 9122 GARDEN GROVE BLVD GARDEN GROVE, CA 92844 | MUTUAL OF OMAHA INSURANCE COMPANY | $566 | — | $566 | 10.00% |
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 | 220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 220 | $2.5M |
| Dental | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 220 | $118K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 220 | $24K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 220 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.