| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROFESSIONAL GROUP MARKETING INC Filed as: PROFESSIONAL GROUP MARKETING, INC. | 50 BROADWAY HAWTHORNE, NY 10532 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $55K | — | $55K | 4.85% |
| GA SOLUTIONS LLC3 Filed as: GA SOLUTIONS, LLC | 370 LEXINGTON AVENUE, SUITE 703 NEW YORK, NY 10017 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $846 | $10K | 9.41% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN INC. | 90 TROY ROAD PO BOX 640 EAST GREENBUSH, NY 12061 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 12.64% |
| PROFESSIONAL PENSIONS INC3 | 10 RESEARCH PKWY WALLINGFORD, CT 06492 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.74% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $51 | $51 | 0.10% |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | 292 | $1.1M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $103K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $103K |
| Life insurance(2 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 145 | $67K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 145 | $53K |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 145 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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.