| 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 | $153K | $6K | $159K | 3.79% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | $11K | $0 | $11K | 6.24% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INSURANCE COMPANY | $10K | $0 | $10K | 16.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED AMERICAN INSURANCE COMPANY | $576 | $0 | $576 | 0.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.82% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 6TH FLOOR NEW YORK, NY 10016 | SHELTERPOINT LIFE INSURANCE COMPANY | $2K | $0 | $2K | 12.24% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | SHELTERPOINT LIFE INSURANCE COMPANY | $752 | $0 | $752 | 5.00% |
| MMG AGENCY INC.3 Filed as: MMG | 1145 FOREST AVENUE STATEN ISLAND, NY 13010 | AXIS INSURANCE COMPANY | $431 | $0 | $431 | 14.99% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 601 PLAZA 3, 6TH FLOOR HARBORSIDE FINANCIAL CENTER JERSEY CITY, NJ 07311 | AXIS INSURANCE COMPANY | $431 | $0 | $431 | 14.99% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA INSURANCE COMPANY | $84 | $0 | $84 | 7.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | TRANSAMERICA INSURANCE COMPANY | $24 | $0 | $24 | 2.20% |
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 | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 29 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 361 | $4.2M |
| Dental | AETNA LIFE INSURANCE COMPANY | 361 | $4.2M |
| Vision | VISION SERVICE PLAN | 167 | $22K |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 202 | $183K |
| Short-term disability | SHELTERPOINT LIFE INSURANCE COMPANY | 202 | $15K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 202 | $183K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 361 | $4.2M |
| Other(2 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 202 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 361 | — |
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.