| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERIVES INC | 30 CENTURY HILL SUITE 200 LATHAM, NY 12110 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC | $23K | $0 | $23K | 3.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE INC | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | EMPIRE HEALTHCHOICE ASSURANCE, INC (G1921) | $3K | $0 | $3K | 5.92% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGY OF VA INC | 11220 ASSET LOOP SUITE 104 MANASSAS, VA 20109 | EMPIRE HEALTHCHOICE ASSURANCE, INC (G1921) | $0 | $691 | $691 | 1.31% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 1133 WESTERCHESTER AVENUE SUITE 136 WEST HARRISON, NY 10604 | EMPIRE HEALTHCHOICE ASSURANCE, INC (G1921) | -$513 | $691 | $178 | 0.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE INC | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY (G0458) | $3K | $434 | $4K | 16.95% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN &BROWN OF NEW YORK INC | 1133 WEST CHESTER AVENUE SUITE N 136 HARRISON, NY 10604 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY (G0458) | $0 | $0 | $0 | 0.00% |
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 | 245 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC | 117 | $638K |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC (G1921) | 85 | $53K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC (G1921) | 85 | $53K |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY (G0458) | 108 | $22K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY (G0458) | 245 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 245 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.