| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID SOLOMONS3 | 140 BROADWAY - 46TH FLOOR NEW YORK, NY 10005 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $50K | $8K | $59K | 4.42% |
| DONALD C SAVOY INC3 Filed as: DONALD C. SAVOY, INC. | 25B HANOVER ROAD-SUITE 220 FLORHAM PARK, NJ 07932 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | — | $31K | $31K | 2.35% |
| DAVID SOLOMONS3 | 140 BROADWAY-46TH FLOOR NEW YORK, NY 10005 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $6K | $538 | $7K | 7.57% |
| DONALD C SAVOY INC3 Filed as: DONALD C SAVOY, INC. | 25B HANOVER ROAD-SUITE 220 FLORHAM PARK, NJ 07932 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | — | $3K | $3K | 3.32% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 207 | $1.3M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 207 | $1.3M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 207 | $1.3M |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 168 | $93K |
| Short-term disability | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 168 | $93K |
| Long-term disability | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 168 | $93K |
| Other | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 168 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 207 | — |
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.
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.