| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKER, INC. | 750 THIRD AVENUE 15TH FL NEW YORK, NY 10017 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $38K | $38K | 2.50% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | $3K | $6K | 23.51% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | COMPANION LIFE INSURANCE COMPANY | $1K | $1K | $3K | 22.35% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL ST. 4TH FLOOR BOSTON, MA 02110 | VISION SERVICE PLAN | $681 | — | $681 | 8.42% |
| EMERSON REID LLC3 Filed as: EMERSON REID, LLC. | 1787 SENTRY PKWY W. VEVA 16 STE 320 BLUE BELL, PA 19422 | GUARDIAN LIFE INSURANE COMPANY OF AMERICA | $322 | $271 | $593 | 9.22% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | COMPANION LIFE INSURANCE COMPANY | $622 | $663 | $1K | 20.66% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | MUTUAL OF OMAHA INSURANCE COMPANY | $168 | $207 | $375 | 22.33% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | MUTUAL OF OMAHA INSURANCE COMPANY | $44 | $47 | $91 | 20.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Contract Administrator; Claims processing Service code 12 | — | $38K |
| RSC INSURANCE BROKER, INC NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 750 THIRD AVENUE 15TH FL NEW YORK, NY 10017 | $38K |
| THE DIFFERENCE CARD NONE | Claims processing; Contract Administrator Service code 12 | 245 MAIN STREET 6TH FL WHITE PLAINS, NY 10606 | $11K |
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 | 110 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $1.5M |
| Dental | GUARDIAN LIFE INSURANE COMPANY OF AMERICA | 94 | $6K |
| Vision | VISION SERVICE PLAN | 63 | $8K |
| Life insurance(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 113 | $20K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 113 | $27K |
| Other(4 contracts, 3 carriers) | CORPORATE COUNSELING ASSOCIATES, INC. | 171 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.