| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAMMACK HEALTH LLC3 | ONE BATTERY PARK PLAZA SUITE 600 NEW YORK, NY 10004 | NORTHEAST DELTA DENTAL | $20K | — | $20K | 1.60% |
| CAMMACK HEALTH LLC3 | ONE BATTERY PARK PLACE SUITE 600 NEW YORK, NY 10004 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $5K | $12K | 3.47% |
| CAMMACK HEALTH LLC3 | ONE BATTERY PARK PLAZA SUITE 600 NEW YORK, NY 10004 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $3K | $8K | 3.42% |
| TETLEY, DAVID A3 | 135 SHETLAND ROAD FAIRFIELD, CT 06430 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $24K | — | $24K | 20.00% |
| CAMMACK HEALTH LLC3 | ONE BATTERY PARK PLAZA SUITE 600 NEW YORK, NY 10004 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $579 | $4K | 9.82% |
| CAMMACK HEALTH LLC3 | ONE BATTERY PARK PLAZA SUITE 600 NEW YORK, NY 10004 | EMPIRE HEALTHCHOICE ASSURANCE / EMPIRE HEALTHCHOICE HMO (133874803) | $408 | — | $408 | 2.74% |
| TETLEY, DAVID A3 | 135 SHETLAND ROAD FAIRFIELD, CT 06430 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $375 | — | $375 | 15.02% |
| CAMMACK HEALTH LLC3 | ONE BATTERY PARK PLAZA SUITE 600 NEW YORK, NY 10004 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $24 | — | $24 | 1.02% |
| CAMMACK HEALTH LLC3 | ONE BATTERY PARK PLAZA SUITE 600 NEW YORK, NY 10004 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $45 | — | $45 | 2.08% |
| CAMMACK HEALTH LLC3 | ONE BATTERY PARK PLAZA SUITE 600 NEW YORK, NY 10004 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $33 | — | $33 | 8.40% |
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 | 1,650 | 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) | 1,650 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE / EMPIRE HEALTHCHOICE HMO (133874803) | 0 | $15K |
| Dental | NORTHEAST DELTA DENTAL | 3,742 | $1.3M |
| Vision | EYEMED VISION CARE - FIDELITY SECURITY LIFE INSURANCE COMPANY OF NY | 2,508 | $192K |
| Life insurance(3 contracts) | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,525 | $366K |
| Long-term disability(2 contracts) | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,525 | $350K |
| Other(4 contracts) | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,525 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,742 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.