| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OMNI ADMINISTRATORS, INC.3 | 14 WALL STREET NEW YORK, NY 10005 | EMBLEMHEALTH | $112K | — | $112K | 3.85% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SVCS | 1133 WESTCHESTER AVENUE, STE S-229 WHITE PLAINS, NY 106043512 | EMBLEMHEALTH | — | $18K | $18K | 0.61% |
| STERLING AND STERLING, INC.3 Filed as: STERLING & STERLING LLC | 135 CROSSWAYS PARK DR., STE 300 WOODBURY, NY 117972005 | UNITED HEALTHCARE INSURANCE COMPANY | $28K | — | $28K | 3.63% |
| OMNI MANAGED HEALTH, INC.3 Filed as: OMNI MANAGED HEALTH INC | 3877 FLATLANDS AVENUE, FL 2 BROOKLYN, NY 112343008 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 0.28% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SVCS LLC | 2677 N MAIN ST., STE 800 SANTA ANA, CA 927056687 | UNITED HEALTHCARE INSURANCE COMPANY | — | $2K | $2K | 0.26% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SVCS | 1133 WESTCHESTER AVENUE, STE S-229 WHITE PLAINS, NY 106043512 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $1K | $1K | 0.14% |
| STERLING AND STERLING, INC.3 Filed as: STERLING & STERLING LLC | PO BOX 9017 WOODBURY, NY 11797 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $14K | — | $14K | 10.01% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SVCS | 12404 PARK CENTRAL DR, STE 400S DALLAS, TX 75251 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $7K | — | $7K | 5.01% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMBLEMHEALTH | 260 | $3.7M |
| Dental | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 141 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.