| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $151K | $0 | $151K | 3.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEIFT SERVICES INC | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | -$267 | $38K | $38K | 0.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEIFT SERVICES INC | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DENTCARE DELIVERY SYSTEMS | $2K | $0 | $2K | 2.61% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | HM LIFE INSURANCE COMPANY OF NEW YORK | $5K | $0 | $5K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $2K | $0 | $2K | 5.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEIFT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $467 | $0 | $467 | 1.18% |
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 | 636 | 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) | 636 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 794 | $4.8M |
| Dental(2 contracts, 2 carriers) | HEALTHPLEX INSURANCE COMPANY | 317 | $197K |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 608 | $55K |
| Life insurance | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | 636 | $39K |
| Prescription drug | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 794 | $4.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 794 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.