| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSMED INS AGENCY INC3 | 500 MAMARONECK AVE SUITE 408 HARRISON, NY 10528 | GUARDIAN | — | $10K | $10K | 2.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Contract Administrator; Direct payment from the plan; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $2.1M |
| STACEY BRAUN ASSOCIATES, INC EIN 13-2884932 NONE | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 51 | — | $221K |
| STEPHEN M PERLITSH EIN 13-3805593 | Legal; Direct payment from the plan Service code 29 | — | $107K |
| COHEN, WEISS AND SIMON, LLP. EIN 25-1919594 NONE | Direct payment from the plan Service code 50 | — | $101K |
| THE SEGAL COMPANY EIN 13-1835864 | Direct payment from the plan; Actuarial Service code 11 | — | $84K |
| HEALTH PLAN SYSTEMS, INC. EIN 01-0589640 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $79K |
| 617 MEDIA GROUP.COM LLC NONE | Direct payment from the plan; Consulting (general) Service code 16 | 282 MOODY STREET, SUITE 314 WALTHAM, MA 02453 | $47K |
| ROGOFF & COMPANY PC EIN 13-2688836 NONE | Direct payment from the plan Service code 50 | — | $32K |
| LEILA MALDONADO EIN 14-0608876 NONE | Legal; Direct payment from the plan Service code 29 | 477 MADISON AVE SIXTH FOLLOR NEW YORK, NY 10017 | $17K |
| BOHUNKA GOLDSTEIN EIN 20-0782535 | Legal; Direct payment from the plan Service code 29 | — | $13K |
| LOCKTIGHT SOLUTIONS EIN 22-3825157 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $12K |
| POINT POLISH EIN 51-8550918 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $9K |
| EMPIRE HEALTHCHOICE HMO, INC. EIN 13-3874803 NONE | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $0 |
| SEGAL SELECT INSURANCE SERVICES, IN EIN 46-0619194 | Insurance brokerage commissions and fees; Direct payment from the plan Service code 50 | — | $0 |
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 | 4,618 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 46 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,664 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 3,216 | $0 |
| Dental | GUARDIAN | 3,234 | $885K |
| Vision | DAVIS VISION | 7,675 | $107K |
| Life insurance | GUARDIAN | 4,241 | $458K |
| Short-term disability | STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK INC | 3,283 | $240K |
| Long-term disability | GUARDIAN | 4,241 | $458K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 3,216 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,675 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.