| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CABOT UNDERWRITERS3 | 216 SUN VISTA COURT NORTH TREASURE ISLAND, FL 33706 | S&S HEALTH | $248K | — | $248K | 6.71% |
| ACCURISK3 | 33 RIVEWRSIDE DR #103 PEMBROOKE, MA 02359 | S&S HEALTH | $101K | — | $101K | 2.72% |
| CHRISTOPHER CONNER3 | 2001 MARCUS AVENUE, SUITE W180 LAKE SUCCESS, NY 11042 | S&S HEALTH | $49K | — | $49K | 1.32% |
| VAN VALEN ASSOCIATES LTD.3 | 50 CARMEN VIEW DR SHIRLEY, NY 11967 | S&S HEALTH | $33K | — | $33K | 0.89% |
| PHIA GROUP3 | 40 PEQUOT WAY CANTON, MA 02021 | S&S HEALTH | $10K | — | $10K | 0.27% |
| VAN VALEN ASSOCIATES LTD.3 Filed as: VAN VALEN ASSOCIATES LTD | 50 CARMEN VIEW DR SHIRLEY, NY 11967 | EMPIRE HEALTHCHOICE ASSURANCE INC | $23K | — | $23K | 3.59% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD HAUPPAUGE, NY 11788 | EMPIRE HEALTHCHOICE ASSURANCE INC | — | $10K | $10K | 1.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES INC EIN 35-0781558 BROKER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing; Float revenue Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $290K |
| ISABEL VAZQUEZ EIN 13-4191811 EMPLOYEE | Direct payment from the plan Service code 50 | — | $107K |
| GLORIA LARRONDO EIN 13-4191811 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $51K |
| COSTAROTHBORT CPAS, LLC EIN 46-5286678 AUDITORS | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $14K |
| HYLANT GROUP INC EIN 35-0781558 BROKER | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | 6714 POINT INVERNESS WAY FORT WAYNE, IN 46804 | $0 |
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 | 456 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 456 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE INC | 81 | $653K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE INC | 81 | $653K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 375 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.