| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NAVA BENEFITS3 | 228 PARK AVENUE SOUTH, PMB 97880 NEW YORK, NY 10003 | ANTHEM BLUE CROSS | $151K | $0 | $151K | 5.28% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SER | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | ANTHEM BLUE CROSS | $0 | $29K | $29K | 1.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | ANTHEM BLUE CROSS | -$654 | $0 | -$654 | -0.02% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SER | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $22K | $2K | $24K | 13.33% |
| ADVOCATE, INC.3 | 228 PARK AVENUE SOUTH NEW YORK, NY 10003 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $7K | — | $7K | 6.90% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SER | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $5K | $5K | 4.93% |
| ADVOCATE, INC.3 | 228 PARK AVENUE SOUTH, PMB 97880 NEW YORK, NY 10003 | FSL NY | $1K | — | $1K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $339 | $0 | $339 | 3.92% |
| TRACY L WILBANKS3 Filed as: TRACY WILBANKS AND OTHER AGENTS | 478 JERSEY AVENUE GREENWOOD LAKE, NY 10925 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $116 | $0 | $116 | 1.34% |
| DEBRA JILL MALONEY3 Filed as: DEBRA MALONEY | 389 LINCOLN AVENUE PORTSMOUTH, NH 03801 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $93 | $0 | $93 | 1.07% |
| ANDREW J JUNIKIEWICZ JR3 Filed as: ANDREW JUNKIKIEWICZ | 22 BROOK HOLLOW DRIVE SINKING SPRING, PA 19608 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $76 | — | $76 | 0.88% |
| CARL SHELOW3 | 4 TRENT LANE NORRISTOWN, PA 19401 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $70 | $0 | $70 | 0.81% |
| ANGELA MONTENEGRO3 | 74 HILLANDALE DRIVE NEW ROCHELLE, NY 10804 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $43 | $0 | $43 | 0.50% |
| DOUGLAS MEIER3 | 23 ROCKLEDGE TERRACE POMPTOM PLAINS, NJ 07444 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $33 | $0 | $33 | 0.38% |
| TRACY D GREEN3 Filed as: TRACY GREEN | 3010 SOUTH DAKOTA AVENUE NE WASHINGTON, DC 20018 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $6 | $0 | $6 | 3.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $4 | $0 | $4 | 2.60% |
| POOJA JAIN3 | 42916 VIA VENETO WAY ASHBURN, VA 20148 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $3 | $0 | $3 | 1.95% |
| ANDREW J JUNIKIEWICZ JR3 Filed as: ANDREW JUNKIKIEWICZ, JR. | 22 BROOK HOLLOW DRIVE SINKING SPRING, PA 19608 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $2 | $0 | $2 | 1.30% |
| DUVYA JAIN3 | 14155 NEWBROOK DRIVE, SUITE 130 CHANTILLY, VA 20151 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $1 | $0 | $1 | 0.65% |
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 | 215 | 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) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS | 287 | $2.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 180 | $107K |
| Vision | FSL NY | 261 | $14K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 212 | $181K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 212 | $181K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 212 | $181K |
| Prescription drug | ANTHEM BLUE CROSS | 287 | $2.9M |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 212 | $190K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.