| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DR SUITE 200 CAMDEN, NJ 08103 | EMBLEMHEALTH | $47K | — | $47K | 3.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $4K | $482 | $5K | 15.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $2K | $260 | $2K | 7.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 100 SUMMIT LAKE DRIVE SUITE 400 VALHALLA, NY 10595 | FSL NY | $282 | — | $282 | 4.61% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUP, LLC | 2 AQUARIUM DRIVE SUITE 200 CAMDEN, NJ 08103 | FSL NY | $24 | — | $24 | 0.39% |
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 | 138 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMBLEMHEALTH | 109 | $1.6M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 113 | $32K |
| Vision | FSL NY | 108 | $6K |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 137 | $32K |
| Long-term disability | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 137 | $32K |
| Prescription drug | EMBLEMHEALTH | 109 | $1.6M |
| Other | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 137 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.