| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRUCE R ROWLANDS3 Filed as: BRUCE R. ROWLANDS | 6 TOWER PLACE ALBANY, NY 12203 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $10K | — | $10K | 2.82% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY INC. | 800 WESTCHESTER AVENUE SUITE N311 RYE BROOK, NY 10573 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $2K | — | $2K | 0.53% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC. | 6 TOWER PLACE ALBANY, NY 12203 | GUARDIAN | $587 | — | $587 | 14.54% |
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 | 28 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 33 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 28 | $437K |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 28 | $354K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 28 | $354K |
| Life insurance | GUARDIAN | 28 | $4K |
| Prescription drug | HEALTHNOW NEW YORK, INC. DBA BLUE CROSS BLUE SHIELD OF WESTERN NY | 5 | $83K |
| Other | GUARDIAN | 28 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 28 | — |
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.