| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1900 CROWN COLONY DR 3RD FL STE 308 QUINCY, MA 02169 | FIRST SYMETRA NATIONAL LIFE INS CO OF NEW YORK | — | $34K | $34K | 2.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER & CO | 2850 GOLF RD 5TH FLR ROLLING MEADOWNS, IL 60008 | FIRST SYMETRA NATIONAL LIFE INS CO OF NEW YORK | $31K | — | $31K | 1.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, LLC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | 1 PENNSYLVANIA PLAZA 8 NEW YORK, NY 10119 | $396K |
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 | 957 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 959 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Prescription drug | FIRST SYMETRA NATIONAL LIFE INS CO OF NEW YORK | 947 | $1.7M |
| Stop-loss / reinsurancereinsurance | FIRST SYMETRA NATIONAL LIFE INS CO OF NEW YORK | 947 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 947 | — |
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.