| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSHALL & STERLING EMPLOYEE BENEFI3 | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC | $50K | — | $50K | 4.00% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | DELTA DENTAL OF NEW YORK | $4K | — | $4K | 5.00% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | UNITED CONCORDIA INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 8.00% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | EMPIRE HEALTHCHOICE ASSURANCE INC | $312 | $245 | $557 | 6.32% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | EMPIRE HEALTHCHOICE ASSURANCE INC | $41 | $42 | $83 | 9.08% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC. | 1000 WOODBURY ROAD, SUITE 403 WOODBURY, NY 11797 | EMPIRE HEALTHCHOICE ASSURANCE INC | $0 | $59 | $59 | 6.46% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC | 136 | $1.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NEW YORK | 128 | $95K |
| Vision(2 contracts) | EMPIRE HEALTHCHOICE ASSURANCE INC | 112 | $10K |
| Prescription drug | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC | 136 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.