| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP, 17TH FLOOR NEW YORK, NY 10005 | EMPIRE HEALTHCHOICE HMO, INC. | $117K | — | $117K | 1.94% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $49K | — | $49K | 1.94% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 1.98% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP, 17TH FLOOR NEW YORK, NY 10005 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $129 | $1K | 0.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 150 EAST 42ND STREET, 16TH FLOOR NEW YORK, NY 10017 | METROPOLITAN LIFE INSURANCE COMPANY | — | $81 | $81 | 0.03% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | FIRST UNUM LIFE INSURANCE COMPANY | $10K | $5K | $15K | 7.47% |
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 | 453 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 29 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 489 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE HMO, INC. | 1,000 | $8.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 776 | $256K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 596 | $203K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 596 | $203K |
| Prescription drug(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE HMO, INC. | 1,000 | $8.6M |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 596 | $203K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,000 | — |
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.