| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY LLC | 340 MADISON AVE 21ST FLOOR NEW YORK, NY 10173 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $52K | $0 | $52K | 4.13% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES LLC | 340 MADISON AVE 21ST FLOOR NEW YORK, NY 10173 | VISION SERVICE PLAN | $418 | $0 | $418 | 7.82% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BOULEVARD 2ND FLOOR HAUPPAUGE, NY 11788 | VISION SERVICE PLAN | $250 | $0 | $250 | 4.68% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY LLC | 340 MADISON AVENUE 21ST FLOOR NEW YORK, NY 10017 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $766 | $0 | $766 | 14.84% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY LLC | 340 MADISON AVE 21ST FLOOR NEW YORK, NY 10173 | AFLAC | $957 | $0 | $957 | 25.63% |
| KIM DYMOND3 | 562 W END AVE STE 4D NEW YORK, NY 10024 | AFLAC | $321 | $0 | $321 | 8.60% |
| ANGELA MONTENEGRO3 | 14 WALL ST STE 8C NEW YORK, NY 10005 | AFLAC | $261 | $0 | $261 | 6.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: ELMER BROWN | 212 E 112TH ST APT 1 NEW YORK, NY 10029 | AFLAC | $209 | $11 | $220 | 5.89% |
| DOUGLAS MEIER3 Filed as: DOUGLAS R. MEIER | 25 ROCKLEDGE TER POMPTON PLAIN, NJ 07444 | AFLAC | $158 | $0 | $158 | 4.23% |
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 | 148 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 148 | $1.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 148 | $1.3M |
| Vision | VISION SERVICE PLAN | 72 | $5K |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 92 | $5K |
| Short-term disability | SHELTERPOINT LIFE INSURANCE COMPANY | 109 | $8K |
| Other(2 contracts, 2 carriers) | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 92 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 148 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.