| 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 | $155K | $9K | $164K | 3.85% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | $12K | $0 | $12K | 6.01% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTON, RI 02852 | UNITED AMERICAN INSURANCE COMPANY | $9K | $0 | $9K | 16.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED AMERICAN INSURANCE COMPANY | $546 | $0 | $546 | 0.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.31% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 6TH FLOOR NEW YORK, NY 10016 | SHELTERPOINT LIFE INSURANCE COMPANY | $2K | $0 | $2K | 13.33% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES INC. | 300 CONNELL DRIVE, SUITE 1100 BERKELEY HEIGHTS, NJ 07922 | SHELTERPOINT LIFE INSURANCE COMPANY | $764 | $0 | $764 | 5.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 499 WASHINGTON BOULEVARD, SUITE 810 JERSEY CITY, NJ 07310 | AXIS INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| MMG AGENCY INC.3 Filed as: MMG AGENCY, INC. | 1145 FOREST AVENUE STATEN ISLAND, NY 10310 | AXIS INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $0 | $2K | $2K | — |
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 | 235 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 31 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 394 | $4.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 394 | $4.3M |
| Vision | VISION SERVICE PLAN | 177 | $22K |
| Life insurance(2 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 225 | $195K |
| Short-term disability | SHELTERPOINT LIFE INSURANCE COMPANY | 225 | $15K |
| Long-term disability(2 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 225 | $195K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 394 | $4.3M |
| Other(3 contracts, 3 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 225 | $204K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 394 | — |
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.