| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD., 5TH FLOOR ROLLING MEADOWS, IL 60008 | EMPIRE HEALTHCHOICE ASSURANCE INC. | $51K | $7K | $58K | 3.13% |
| MDG ASSOCIATES OF CONNECTICUT3 Filed as: MDG BENEFIT SOLUTIONS | 34 EAST INDUSTRIAL ROAD, SUITE 5 BRANFORD, CT 06405 | EMPIRE HEALTHCHOICE ASSURANCE INC. | $17K | — | $17K | 0.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | PO BOX 3009 21ST FLOOR ARLINGTON HEIGHT, IL 60006 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | $13K | — | $13K | 7.92% |
| MDG ASSOCIATES OF CONNECTICUT3 Filed as: MDG BENEFIT SOLUTIONS | 100 PARK AVE 16TH FLOOR NEW YORK, NY 10017 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | $5K | — | $5K | 2.89% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE INC. | 190 | $1.9M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE INC. | 190 | $1.9M |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 120 | $161K |
| Short-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 120 | $161K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 120 | $161K |
| Other | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 120 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.