| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GLOBAL COVERAGE INC.3 | 9 E 37TH ST 4TH FLOOR NEW YORK, NY 10016 | OXFORD HEALTH INSURANCE, INC | $34K | — | $34K | 1.57% |
| MAURICE LYONS3 Filed as: MAURICE LYONS LTD | 301 MADISON AVE FL 4 NEW YORK, NY 10017 | OXFORD HEALTH INSURANCE, INC | $26K | — | $26K | 1.18% |
| BRYAN ERDHEIM3 | 301 MADISON AVE FL 4 NEW YORK, NY 10017 | OXFORD HEALTH INSURANCE, INC | $26K | — | $26K | 1.18% |
| CAPSTONE BROKERAGE INC.3 Filed as: CAPSTONE BROKERAGE INC | 2675 S JONES BLVD STE 102 LAS VEGAS, NV 89146 | PROMINENCE HEALTH PLAN | $56K | — | $56K | 5.00% |
| CAPSTONE BROKERAGE INC.3 Filed as: CAPSTONE BROKERAGE INC | 8681 W SANARA AVE STE 100 LAS VEGAS, NV 89117 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $5K | $20K | 7.94% |
| LYONS MAURICE LTD3 | DBA THE MEDICAL LINK 301 MADISON AVENUE 4TH FLOOR NEW YORK, NY 10017 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $677 | $3K | 9.95% |
| MARUICE LYONS LTD3 | 301 MADISON AVE FL 4 NEW YORK, NY 100178103 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 7.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE | 100 SUNNYSIDE BLVD. WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF BOSTON & NEW YORK | $146 | — | $146 | 10.01% |
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 | 408 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 411 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | OXFORD HEALTH INSURANCE, INC | 389 | $3.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 275 | $248K |
| Vision(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 520 | $277K |
| Life insurance(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 503 | $273K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 275 | $248K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 503 | $281K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 520 | — |
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.