| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC. | 6 TOWER PLACE ALBANY, NY 12203 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $23K | — | $23K | 3.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC. | 1133 WESTCHESTER AVENUE SUITE N136 WEST HARRISON, NY 10604 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $3K | — | $3K | 5.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGY OF VA INC. | 8570 MAGELLAN PARKWAY STE 1100 RICHMOND, VA 23337 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $0 | $646 | $646 | 0.94% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC. | 1133 WESTCHESTER AVENUE SUITE N136 WEST HARRISON, NY 10604 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $3K | — | $3K | 14.44% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGY OF VA INC. | 8570 MAGELLAN PARKWAY STE 1100 RICHMOND, VA 23227 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $0 | $319 | $319 | 1.44% |
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 | 126 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | 80 | $621K |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 158 | $69K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 158 | $69K |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 126 | $22K |
| Other | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 126 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.