| 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 | $14K | $14K | 4.61% |
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY-SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $6K | $6K | 4.61% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS JAMISON LLC | 20 COMMERCE DRIVE, BSMT 2 CRANFORD, NJ 070163617 | WESCO INSURANCE COMPANY | $4K | — | $4K | 6.19% |
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $575 | $575 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Float revenue; Claims processing Service code 12 | 1351 WM. HOWARD TAFT RD. CINCINNATI, OH 452061721 | $768K |
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 | 403 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 439 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 845 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC | 1,527 | $12.2M |
| Dental | DELTA DENTAL OF NEW YORK | 1,700 | $862K |
| Vision | DAVIS VISION | 3,530 | $156K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 405 | $311K |
| Short-term disability | WESCO INSURANCE COMPANY | 436 | $62K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 405 | $130K |
| Prescription drug | CVS PHARMACY, INC | 1,888 | $6.5M |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC | 1,527 | $10.5M |
| Other(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 405 | $311K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,530 | — |
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.