| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADALSON INC3 | 50 JERICHO TURNPIKE SUITE 110 JERICHO, NY 11753 | ZURICH NORTH AMERICAN INSURANCE COMPANY | $28K | — | $28K | 6.55% |
| ADALSON INC3 | 50 JERICHO TURNPIKE SUITE 110 JERICHO, NY 11753 | EMPIRE HEALTH CHOICE ASSURANCE INC. | $9K | — | $9K | 3.44% |
| ADALSON INC3 | 50 JERICHO TURNPIKE SUITE 110 JERICHO, NY 11753 | SUNLIFE AND HEALTH INSURANCE CO (US) | $566 | — | $566 | 7.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $80K |
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 | 164 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTH CHOICE ASSURANCE INC. | 50 | $268K |
| Vision | EMPIRE HEALTH CHOICE ASSURANCE INC. | 50 | $268K |
| Life insurance | SUNLIFE AND HEALTH INSURANCE CO (US) | 114 | $7K |
| Stop-loss / reinsurancereinsurance | ZURICH NORTH AMERICAN INSURANCE COMPANY | 104 | $421K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.