| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CARPEZZI-LIEBERT GROUP INC3 | 172 MAIN ST NANUET, NY 10954 | EMPIRE HEALTHCHOICE ASSURANCE, INC. (G1921) | $66K | — | $66K | 3.29% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INS SERVICES INC | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | EMPIRE HEALTHCHOICE ASSURANCE, INC. (G1921) | $39K | — | $39K | 1.95% |
| GREATER METRO AGENCY INC3 | 2003 JERICHO TPKE NEW HYDE, NY 11040 | EMPIRE HEALTHCHOICE ASSURANCE, INC. (G1921) | -$15 | — | -$15 | -0.00% |
| GA SOLUTIONS LLC3 | 370 LEXINGTON AVENUE SUITE 703 NEW YORK, NY 10017 | GUARDIAN | $9K | $4K | $13K | 10.27% |
| GA SOLUTIONS LLC3 | 370 LEXINGTON AVENUE SUITE 703 NEW YORK, NY 10017 | GUARDIAN | $8K | $4K | $12K | 12.67% |
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 | 171 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. (G1921) | 376 | $2.0M |
| Dental | GUARDIAN | 150 | $93K |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 145 | $22K |
| Life insurance | GUARDIAN | 245 | $125K |
| Long-term disability | GUARDIAN | 245 | $125K |
| Other | GUARDIAN | 245 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 376 | — |
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.
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.