| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN NEW YORK, NY 10018 | OXFORD HEALTH INSURANCE, INC. | $58K | $0 | $58K | 2.07% |
| USI INSURANCE SERVICES LLC3 | 725 RXR PLAZA, EAST TOWER UNIONDALE, NY 11556 | OXFORD HEALTH INSURANCE, INC. | $33K | $0 | $33K | 1.18% |
| MIDDLEGATE INSURANCE AGENCY3 | 15 WEST 38TH STREET, SUITE 1018 NEW YORK, NY 10018 | OXFORD HEALTH INSURANCE, INC. | $8K | $0 | $8K | 0.30% |
| EMERSON REID LLC3 Filed as: EMERSON REID, LLC | 1787 SENTRY PARKWAY WEST VEVA 16 SUITE 320 BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $5K | $20K | 15.07% |
| ACRISURE LLC3 Filed as: CHERNOFF DIAMOND AND COMPANY, LLC. | 725 RXR PLAZA, EAST TOWER UNIONDALE, NE 11556 | SUN LIFE AND HEALTH INSURANCE COMPANY | $4K | $0 | $4K | 4.20% |
| EMERSON REID LLC3 Filed as: EMERSON REID, LLC | 1787 SENTRY PARKWAY WEST VEVA 16 SUITE 320 BLUE BELL, PA 19422 | SUN LIFE AND HEALTH INSURANCE COMPANY | $2K | $0 | $2K | 2.35% |
| USI INSURANCE SERVICES LLC3 | 725 RXR PLAZA, EAST TOWER UNIONDALE, NY 11556 | SUN LIFE AND HEALTH INSURANCE COMPANY | $564 | $0 | $564 | 0.63% |
| CHRISTOPHER THOMAS SMITH3 | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $596 | $5K | 42.23% |
| ACRISURE LLC3 Filed as: CHERNOFF DIAMOND AND COMPANY, LLC. | 725 RXR PLAZA, EAST TOWER UNIONDALE, NE 11556 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $170 | $2K | 17.32% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL HOLDINGS, INC. | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $142 | $142 | 1.31% |
| CHRISTOPHER THOMAS SMITH3 | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $489 | $4K | 48.30% |
| ACRISURE LLC3 Filed as: CHERNOFF DIAMOND AND COMPANY, LLC. | 725 RXR PLAZA, EAST TOWER UNIONDALE, NE 11556 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | $140 | $2K | 19.81% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL HOLDINGS, INC. | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $117 | $117 | 1.51% |
| ACRISURE LLC3 Filed as: CHERNOFF DIAMOND AND COMPANY, LLC. | 725 RXR PLAZA, EAST TOWER UNIONDALE, NE 11556 | FSL NY | $630 | $0 | $630 | 9.17% |
| MIDDLEGATE INSURANCE AGENCY3 | 15 WEST 38TH STREET, SUITE 1018 NEW YORK, NY 10018 | FSL NY | $57 | $0 | $57 | 0.83% |
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 | 304 | 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) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OXFORD HEALTH INSURANCE, INC. | 396 | $2.8M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $134K |
| Vision | FSL NY | 165 | $7K |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY | 304 | $90K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 11 | $19K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY | 304 | $90K |
| Prescription drug | OXFORD HEALTH INSURANCE, INC. | 396 | $2.8M |
| Other | SUN LIFE AND HEALTH INSURANCE COMPANY | 304 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 396 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.