| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FNA INSURANCE SERVICES INC | 180 RIVER ROAD SUMMIT, NJ 07901 | THE GUARDIAN | $4K | $2K | $6K | — |
| WAG NY INC | 250 CROSSWAYS PK DR WOODBURY, NY 11797 | THE GUARDIAN | $12 | — | $12 | — |
| MARSHALL & STERLING EMPLOYEE BENEFI Filed as: MARSHALL & STERLING INC | 110 MAIN STREET POUGHKEESIE, NY 12601 | OXFORD INSURANCE INC. | $38K | — | $38K | — |
| FNA INSURANCE SERVICES INC Filed as: FNA INSURANCE SERVICES INC. | 1000 WOODBURY ROAD WOODBURY, NY 11797 | OXFORD INSURANCE INC. | — | $12K | $12K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SERVICE STATION DEALERS OF GREAT NY EIN 13-5672542 PLAN SPONSOR | Contract Administrator Service code 13 | 421 WAVERLY AVNUE MAMARONECK, NY 10543 | $46K |
| LILLING & COMPANY EIN 13-3447681 NONE | Accounting (including auditing) Service code 10 | 10 CUTTER MILL ROAD GREAT NECK, NY 11021 | $12K |
| JACKSON LEWIS PC EIN 46-3862389 NONE | Legal Service code 29 | 1133 WESTCHESTER AVENUE WEST HARRISON, NY 10604 | $12K |
| SACCO CPA LLP EIN 46-2911697 NONE | Accounting (including auditing) Service code 10 | 200 BUSINESS PARK DRIVE ARMONK, NY 10504 | $12K |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CARE CONNECTS | 118 | $0 |
| Dental | THE GUARDIAN | 37 | $0 |
| Vision | VSP | 6 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 118 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.