| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | PO BOX 350 CONSHOHCKEN, PA 19428 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $75K | $9K | $84K | 4.40% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN. SVCS | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $0 | $25K | $25K | 1.31% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | PO BOX 350 CONSHOHCKEN, PA 19428 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $4K | $927 | $5K | 12.73% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN. SVCS | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $0 | $4K | $4K | 8.92% |
| ROBERT E. BRUNSON3 Filed as: ROBERT BRUNSON | 460 WEST 147TH STREET, APARTMENT 66 NEW YORK, NY 10031 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $1K | $80 | $1K | 9.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $457 | $0 | $457 | 3.35% |
| DOUGLAS MEIER3 | 23 ROCKLEDGE TERRACE POMPTON PLAINS, NJ 07444 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $243 | $19 | $262 | 1.92% |
| SHARON A MARTIN-TOUSSAINT3 Filed as: SHARON MARTIN-TOUSSAINT | 231 PRIMROSE AVENUE MOUNT VERNON, NY 10552 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $156 | $19 | $175 | 1.28% |
| IVAN M SERVAIS3 Filed as: IVAN SERVAIS | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $95 | $0 | $95 | 0.70% |
| ALVARO MONTENEGRO3 | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $58 | $0 | $58 | 0.43% |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 163 | $1.9M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 163 | $1.9M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 134 | $12K |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 165 | $42K |
| Short-term disability | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | 8 | $14K |
| Long-term disability | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 165 | $42K |
| Prescription drug | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 163 | $1.9M |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 165 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.