| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $17K | — | $17K | 4.97% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 8.75% |
| UNKNOWN3 | UNKNOWN NEW YORK, NY 10022 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 4.16% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $74 | $74 | 0.05% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | VISION SERVICE PLAN | $2K | — | $2K | 3.11% |
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 | 177 | 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) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 244 | $349K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 244 | $349K |
| Vision | VISION SERVICE PLAN | 228 | $69K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 256 | $154K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 256 | $154K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 256 | $154K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 244 | $349K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 256 | $154K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 256 | — |
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.