| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTEN GROUP INC.3 Filed as: CHRISTEN INSURANCE, INC. | UNKNOWN NEW YORK, NY 10023 | TRIPLE S SALUDE, INC. | $19K | — | $19K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 190 RIVER ROAD, 1ST FLOOR SUMMIT, NJ 07901 | UNITED HEALTHCARE INSURANCE COMPANY | $12K | — | $12K | 9.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 190 RIVER ROAD, 1ST FLOOR SUMMIT, NJ 07901 | ACE AMERICAN INSURANCE COMPANY | $17K | — | $17K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES, INC | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ACE AMERICAN INSURANCE COMPANY | — | $17K | $17K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 39000 SAN FRANCISCO, CA 94139 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | $5K | — | $5K | 9.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 64 MONROE AVENUE NW, SUITE 300 GRAND RAPIDS, MI 49503 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | — | $605 | $605 | 1.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | — | $378 | $378 | 0.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | — | $27 | $27 | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 823239 PHILADELPHIA, PA 19182 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 3.00% |
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 | 1,491 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 206 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,697 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TRIPLE S SALUDE, INC. | 70 | $540K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 92 | $55K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 2,006 | $131K |
| Life insurance | CIGNA LIFE INSRUANCE COMPANY OF NEW YORK | 1,491 | $0 |
| Prescription drug(2 contracts, 2 carriers) | TRIPLE S SALUDE, INC. | 70 | $540K |
| Other(2 contracts, 2 carriers) | ACE AMERICAN INSURANCE COMPANY | 3,300 | $171K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,300 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.