| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HERBERT L. JAMISON & CO. LLC3 Filed as: HERBERT L. JAMISON LLC | 20 COMMERCE DRIVE 2ND FLOOR CRANFORD, NJ 07106 | DELTA DENTAL OF NEW YORK | $582 | — | $582 | 0.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF NEW YORK EIN 11-1980218 NONE | Claims processing Service code 12 | 575 MADISON AVENUE SUITE 1006 NEW YORK, NY 10022 | $9K |
| HERBERT JAMISON EIN 13-1684892 NONE | Insurance agents and brokers Service code 22 | 20 COMMERCE DRIVE 2ND FLOOR CRANFORD, NJ 07016 | $582 |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW YORK | 160 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.