| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AETNA LIFE INSURANCE COMPANY | $206K | $19K | $225K | 3.95% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $13K | $0 | $13K | 5.55% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 669 RIVER DRIVE CENTER II SUITE 305 ELMWOOD PARK, NJ 07407 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $5K | $6K | $11K | 4.79% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $0 | $4K | $4K | 1.79% |
| AMWINS3 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INSURANCE COMPANY | $11K | $0 | $11K | 16.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED AMERICAN INSURANCE COMPANY | $582 | $0 | $582 | 0.87% |
| MMG AGENCY INC.3 Filed as: MMG AGENCY, INC. | 1145 FOREST AVENUE STATEN ISLAND, NY 10310 | FEDERAL INSURANCE COMPANY | $7K | $0 | $7K | 15.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 499 WASHINGTON BOULEVARD JERSEY CITY, NJ 07310 | FEDERAL INSURANCE COMPANY | $7K | $0 | $7K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.81% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 6TH FLOOR NEW YORK, NY 10016 | SHELTERPOINT LIFE INSURANCE COMPANY | $2K | $0 | $2K | 12.03% |
| REUBEN WARNER ASSOCIATES, INC.3 | 300 CONNELL DRIVE, SUITE 1100 BERKELEY HEIGHTS, NJ 07922 | SHELTERPOINT LIFE INSURANCE COMPANY | $940 | — | $940 | 5.00% |
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 | 285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 28 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 490 | $5.8M |
| Dental | AETNA LIFE INSURANCE COMPANY | 490 | $5.7M |
| Vision | VISION SERVICE PLAN | 207 | $28K |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 271 | $238K |
| Short-term disability | SHELTERPOINT LIFE INSURANCE COMPANY | 268 | $19K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 271 | $238K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 490 | $5.7M |
| Other(3 contracts, 3 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 310 | $331K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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.