| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSE & KIERNAN INC3 | 99 TROY RD PO BOX 640 EAST GREENBUSH, NY 12061 | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC | $268K | $0 | $268K | 4.27% |
| ROSE & KIERNAN INC3 | 99 TROY RD PO BOX 640 EAST GREENBUSH, NY 12061 | DELTA DENTAL OF NEW YORK | $57K | $0 | $57K | 10.00% |
| ROSE & KIERNAN INC3 | 99 TROY RD PO BOX 640 EAST GREENBUSH, NY 12061 | HARTFORD LIFE INSURANCE CO | $12K | $2K | $15K | 5.15% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN | 99 TROY RD PO BOX 640 EAST GREENBUSH, NY 12061 | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC | $28K | $0 | $28K | 10.00% |
| ROSE & KIERNAN INC3 | 99 TROY RD PO BOX 640 EAST GREENBUSH, NY 12061 | EMPIRE HEALTH CHOICE ASSURANCE INC | $2K | $0 | $2K | 4.01% |
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 | 1,281 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 141 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,422 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC | 1,012 | $6.5M |
| Dental | DELTA DENTAL OF NEW YORK | 1,209 | $571K |
| Vision | EMPIRE HEALTH CHOICE ASSURANCE INC | 827 | $38K |
| Life insurance | HARTFORD LIFE INSURANCE CO | 610 | $289K |
| Long-term disability | HARTFORD LIFE INSURANCE CO | 610 | $289K |
| Prescription drug(2 contracts) | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC | 1,012 | $6.5M |
| Other | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC | 1,012 | $6.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,209 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.