| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | 90 KREIGER LANE GLASTONBURY, CT 06033 | SECURITY MUTUAL LIFE INSURANCE OF NEW YORK | $24K | — | $24K | 10.00% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | 90 KRIEGER LANE GLASTONBURY, CT 06033 | SECURITY MUTUAL LIFE INSURANCE CO OF NEW YORK | $6K | — | $6K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 TPA | Claims processing; Contract Administrator; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 12 | — | $1.2M |
| EXPRESS SCRIPTS INC. EIN 31-1714795 PBM | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue Service code 12 | — | $0 |
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 | 1,514 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,514 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTH CHOICE ASSURANCE, INC | 1,514 | $1.1M |
| Dental | EMPIRE HEALTH CHOICE ASSURANCE, INC | 1,514 | $1.1M |
| Vision | EMPIRE HEALTH CHOICE ASSURANCE, INC | 1,514 | $1.1M |
| Life insurance | SECURITY MUTUAL LIFE INSURANCE OF NEW YORK | 1,214 | $236K |
| Long-term disability | SECURITY MUTUAL LIFE INSURANCE CO OF NEW YORK | 284 | $61K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTH CHOICE ASSURANCE, INC | 1,514 | $1.1M |
| Other | SECURITY MUTUAL LIFE INSURANCE OF NEW YORK | 1,214 | $236K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,514 | — |
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."
No prospect flags tripped on this filing.