| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GOLD SKY BENEFITS LLC3 | 40-29 235TH STREET LITTLE NECK, NY 11363 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $157K | $15K | $173K | 4.36% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY ROAD, SUTIE 403 WOODBURY, NY 11797 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $0 | $68K | $68K | 1.73% |
| MICHAEL PONTILLO3 | 40-29 235TH STREET DOUGLASTON, NY 11363 | EQUITABLE | $24K | — | $24K | 15.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | EQUITABLE | $8K | $0 | $8K | 5.22% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMIN, INC | PO BOX 9201 AUSTIN, TX 78766 | EQUITABLE | — | $6K | $6K | 4.00% |
| GOLD SKY BENEFITS LLC3 | 4029 235TH STREET DOUGLASTON, NY 11363 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 9.79% |
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 | 264 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 536 | $4.0M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 536 | $4.0M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 536 | $4.0M |
| Life insurance | EQUITABLE | 264 | $161K |
| Short-term disability | EQUITABLE | 264 | $161K |
| Long-term disability | EQUITABLE | 264 | $161K |
| Prescription drug | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 536 | $4.0M |
| Other(2 contracts, 2 carriers) | EQUITABLE | 264 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 536 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.