| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY-SCHENECTADY ROAD LATHAM, NY 121102424 | DELTA DENTAL OF NEW YORK | $0 | $51K | $51K | 5.50% |
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $11K | $11K | 4.61% |
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY-SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $9K | $9K | 4.61% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 103140000 | FEDERAL INSURANCE COMPANY | $70K | — | $70K | 35.00% |
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY-SCHENECTADY ROAD LATHAM, NY 121102424 | DAVIS VISION | $0 | $7K | $7K | 5.31% |
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $604 | $604 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | 1351 WM. HOWARD TAFT RD. CINCINNATI, OH 452061721 | $677K |
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 | 455 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 359 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 814 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC | 1,372 | $8.4M |
| Dental | DELTA DENTAL OF NEW YORK | 1,812 | $923K |
| Vision | DAVIS VISION | 3,630 | $131K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 468 | $258K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 466 | $202K |
| Prescription drug | CVS PHARMACY, INC | 1,743 | $5.2M |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC | 1,372 | $6.5M |
| Other(3 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 469 | $459K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,630 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.