| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 MERIDIAN CENTRE BOULEVARD SUITE 100 ROCHESTER, NY 14618 | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | $26K | $0 | $26K | 4.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK, INC. | $11K | $0 | $11K | 3.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 30 CENTURY HILL. SUITE 200 LATHAM, NY 12110 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $11K | $0 | $11K | 6.67% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE SUITE 500 CHARLOTTE, NC 28210 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $2K | $0 | $2K | 1.34% |
| DELTA DENTAL OF NEW YORK3 Filed as: DELTA DENTAL OF NEW YORK, INC. | UNKNOWN ALBANY, NY 12205 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $1K | $0 | $1K | 0.74% |
| CAPITAL DISTRICT PHYSICIANS HEALTH3 Filed as: CAPITAL DISTRICT PHYSICIAN'S HEALTH | 500 PATROON CREEK BOULEVARD ALBANY, NY 12206 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $17 | $0 | $17 | 0.01% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE SUITE 500 CHARLOTTE, NC 28210 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | $0 | $10K | 12.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | $0 | $4K | 5.61% |
| DANIELLE M BRANCATO HOUSE3 Filed as: DANIELLE M. BRANCATO | 184 EDIE ROAD, SUITE A SARATOGA SPRINGS, NY 12866 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 4.26% |
| EPSIX, INC.3 | 3300 NORTH SCOTTSDALE ROAD APARTMENT 4020 SCOTTSDALE, AZ 85251 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 3.40% |
| MELISSA A. STEWART3 | 184 EDIE ROAD, SUITE A SARATOGA, NY 12866 | CONTINENTAL AMERICAN INSURANCE COMPANY | $868 | $0 | $868 | 1.24% |
| LINDSAY ROCK SWARTZ3 | 31 AMELIA DRIVE SCHENECTADY, NY 12309 | CONTINENTAL AMERICAN INSURANCE COMPANY | $533 | $0 | $533 | 0.76% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE CHARLOTTE, NC 28210 | CONTINENTAL AMERICAN INSURANCE COMPANY | $528 | $0 | $528 | 0.76% |
| KRISTA ANNE ROTONDI3 Filed as: KRISTA A. GRASSIA AND OTHER AGENTS | 5 PINE WEST PLAZA, SUITE 503 ALBANY, NY 12205 | CONTINENTAL AMERICAN INSURANCE COMPANY | -$54 | $0 | -$54 | -0.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $3K | $2K | $5K | 7.08% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE SUITE 510 CHARLOTTE, NC 28210 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | $1K | $2K | 9.84% |
| LOCKTON COMPANIES, LLC3 | PO BOX 741738 ATLANTA, GA 30374 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $1K | $0 | $1K | 9.80% |
| LOCKTON COMPANIES, LLC3 | PO BOX 741738 ATLANTA, GA 30374 | VISION SERVICE PLAN | $110 | $0 | $110 | 4.93% |
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 | 222 | 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) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 182 | $1.2M |
| Dental(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 222 | $77K |
| Vision | VISION SERVICE PLAN | 117 | $2K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 232 | $21K |
| Short-term disability(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 232 | $91K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 232 | $21K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 89 | $1.1M |
| Other(3 contracts, 3 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 232 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 232 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.