| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HENRY MOYER3 | 35 EAST 75TH STREET, APT. 15D NEW YORK, NY 10021 | METROPOLITAN LIFE INSURANCE COMPANY | $94K | — | $94K | 1.94% |
| FRENKEL BENEFITS LLC3 | 350 HUDSON STREET, 4TH FLOOR NEW YORK, NY 10014 | METROPOLITAN LIFE INSURANCE COMPANY | $47K | $3K | $50K | 1.04% |
| AMERICAN BENEFITS & COMPENSAT. SYS3 | 99 PARK AVE, 25TH FL NEW YORK, NY 10016 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $49K | — | $49K | 8.00% |
| FRENKEL BENEFITS LLC3 | 350 HUDSON STREET, 4TH FLOOR NEW YORK, NY 10014 | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $6K | — | $6K | 4.15% |
| FRENKEL BENEFITS LLC3 | 350 HUDSON STREET, 4TH FLOOR NEW YORK, NY 10014 | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $992 | — | $992 | 4.96% |
| FRENKEL BENEFITS LLC3 | 350 HUDSON STREET, 4TH FLOOR NEW YORK, NY 10014 | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $110 | — | $110 | 5.01% |
| FRENKEL BENEFITS LLC3 | 350 HUDSON STREET, 4TH FLOOR NEW YORK, NY 10014 | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $46 | — | $46 | 4.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES LLC EIN 47-0854646 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $1.2M |
| DELTA DENTAL OF NEW YORK EIN 11-1980218 ADMINISTRATOR | Claims processing Service code 12 | — | $49K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $40K |
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 | 1,501 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 60 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,561 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 47 | $822K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 47 | $611K |
| Vision(4 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 1,480 | $163K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,470 | $4.8M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,470 | $4.8M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,470 | $4.8M |
| Prescription drug | KAISER FOUNDATION HEALTH PLANS INC. | 45 | $210K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK | 1,872 | $2.5M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,470 | $5.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,872 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.