| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $12K | $12K | 4.58% |
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY-SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $6K | $6K | 4.60% |
| HERBERT L. JAMISON & CO. LLC3 | 20 COMMERCE DRIVE, BSMT 2 CRANFORD, NJ 070163617 | WESCO INSURANCE COMPANY | $4K | — | $4K | 9.55% |
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $608 | $608 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Claims processing; Contract Administrator; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 1351 WM. HOWARD TAFT RD. CINCINNATI, OH 452061721 | $803K |
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 | 405 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 409 | 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)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC | 1,484 | $10.1M |
| Dental | DELTA DENTAL OF NEW YORK | 1,751 | $899K |
| Vision | DAVIS VISION | 3,437 | $153K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 416 | $276K |
| Short-term disability | WESCO INSURANCE COMPANY | 457 | $41K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 416 | $125K |
| Prescription drug | CVS PHARMACY, INC | 1,842 | $6.3M |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC | 1,484 | $8.4M |
| Other(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 416 | $276K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,437 | — |
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.