| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| E BENEFIT SOLUTION INC3 | 21704 NORTHERN BLVD BAYSIDE, NY 11361 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $24 | $75K | $75K | 2.00% |
| DONALD C SAVOY INC3 | 25B HANOVER ROAD #B SUITE 220 FLORHAM PARK, NJ 07932 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $75K | $75K | 2.00% |
| SAVOY ASSOCIATES3 | 25B HANOVER ROAD SUITE 220 FLORHAM PARK, NJ 07932 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $17K | $6K | $22K | 6.65% |
| E BENEFIT SOLUTION INC3 | 21704 NORTHERN BLVD BAYSIDE, NY 11361 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $19K | — | $19K | 5.56% |
| E BENEFIT SOLUTION INC3 | 21704 NORTHERN BLVD BAYSIDE, NY 11361 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| SAVOY ASSOCIATES3 | 25B HANOVER ROAD #B SUITE 220 FLORHAM PARK, NJ 07932 | FIRST UNUM LIFE INSURANCE COMPANY | $562 | $450 | $1K | 9.01% |
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 | 272 | 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) | 275 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 272 | $3.8M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 272 | $4.1M |
| Vision | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 269 | $334K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 268 | $11K |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 268 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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.