| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 677 BROADWAY, 4TH FLOOR ALBANY, NY 12207 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $36K | — | $36K | 4.14% |
| CAROL SENETA3 | 4 HARVEY WAY AVERILL PARK, NY 12018 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $172 | — | $172 | 1.10% |
| AHL-ALLSTATE3 | 1776 AHL DRIVE JACKSONVILLE, FL 32224 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $21 | — | $21 | 0.13% |
| TIMOTHY BERRYHILL3 | 1789 WESTERN AVENUE ALBANY, NY 12203 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $15 | — | $15 | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 677 BROADWAY, 4TH FLOOR ALBANY, NY 12207 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $0 | — | $0 | 0.00% |
| CAROL SENETA3 | 4 HARVEY WAY AVELILL PARK, NY 12018 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $722 | — | $722 | 24.07% |
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 | 123 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | 123 | $900K |
| Life insurance | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | 12 | $16K |
| Prescription drug(2 contracts) | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | 123 | $881K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.