| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUGGIERI CONSULTING GROUP LLC3 Filed as: RUGGIERI CONSULTING | 355 LEXINGTON AVENUE 22ND FLOOR NEW YORK, NY 10017 | AETNA LIFE INSURANCE CO. | $12K | $0 | $12K | 3.48% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | AETNA LIFE INSURANCE CO. | $7K | $0 | $7K | 1.96% |
| PHILIP RUGGIERI3 | 355 LEXINGTON AVE NEW YORK, NY 10017 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $9K | $0 | $9K | 12.65% |
| PHILIP RUGGIERI3 | 355 LEXINGTON AVE NEW YORK, NY 10017 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $5K | $0 | $5K | 8.84% |
| ROBERT D WOLF3 Filed as: ROBERT D. WOLF III | 511 GRASSMERE AVE INTERLAKEN, NJ 07712 | UNION SECURITY INSURANCE COMPANY | $2K | $0 | $2K | 6.29% |
| ROBERT D WOLF3 | 355 LEXINGTON AVE 22ND FL NEW YORK, NY 10017 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $1K | $0 | $1K | 4.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other fees; Other services; Float revenue Service code 12 | — | $754K |
| ROBERT D WOLF EIN 13-8483795 NONE | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $252K |
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 | 778 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 794 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 1,049 | $774K |
| Dental | AETNA LIFE INSURANCE CO. | 674 | $333K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 709 | $31K |
| Life insurance(2 contracts) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 742 | $124K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 168 | $36K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 1,049 | $774K |
| Other(2 contracts) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 742 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,049 | — |
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."
No prospect flags tripped on this filing.