| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | AETNA LIFE INSURANCE COMPANY | $98K | $10K | $108K | 3.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN WARREN, NJ 07059 | AETNA LIFE INSURANCE COMPANY | — | $115 | $115 | 0.00% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203510 DALLAS, TX 75320 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $8K | $4K | $12K | 10.22% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA INSURANCE COMPANY | $6K | — | $6K | 7.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | TRANSAMERICA INSURANCE COMPANY | $2K | — | $2K | 2.20% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203510 DALLAS, TX 75320 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $1K | $391 | $2K | 4.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | VISION SERVICE PLAN | $1K | — | $1K | 5.67% |
| WELLS FARGO INSURANCE SERVICES3 | 330 MADISON AVENUE, 7TH FLOOR NEW YORK, NY 10017 | SHELTERPOINT GROUP, INC. | $1K | — | $1K | 13.28% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | SHELTERPOINT GROUP, INC. | $420 | — | $420 | 4.43% |
| FRENKEL BENEFITS LLC3 Filed as: FRENKEL AND COMPANY | 601 PLAZA 3, 6TH FLOOR JERSEY CITY, NJ 07311 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $427 | — | $427 | 14.99% |
| MMG AGENCY INC.3 Filed as: MMG AGENCY, INC. | 32 BROADWAY, SUITE 1818 NEW YORK, NY 10004 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $427 | — | $427 | 14.99% |
| MMG AGENCY INC.3 Filed as: MMG AGENCY, INC. | 32 BROADWAY, SUITE 1818 NEW YORK, NY 10004 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $182 | — | $182 | 15.04% |
| FRENKEL BENEFITS LLC3 Filed as: FRENKEL AND COMPANY | 601 PLAZA 3, 6TH FLOOR HARBORSIDE FINANCIAL CENTER JERSEY CITY, NJ 07311 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $182 | — | $182 | 15.04% |
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 | 219 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 45 | 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)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 325 | $2.8M |
| Dental | AETNA LIFE INSURANCE COMPANY | 325 | $2.7M |
| Vision | VISION SERVICE PLAN | 155 | $19K |
| Life insurance(2 contracts) | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 196 | $162K |
| Short-term disability | SHELTERPOINT GROUP, INC. | 203 | $9K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 196 | $119K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 325 | $2.7M |
| Other(3 contracts, 2 carriers) | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 219 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 325 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.