| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 100 PINEWOOD LANE, SUITE 301 WARRENDALE, PA 15086 | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC. | $15K | — | $15K | 3.86% |
| OLIVIER VANDYK INSURANCE3 | 2780 44TH STREET SW WYOMING, MI 49519 | DELTA DENTAL OF PENNSYLVANIA | $3K | $0 | $3K | 10.00% |
| OLIVIER VANDYK INSURANCE3 | 2780 44TH STREET SW WYOMING, MI 49519 | COMPANION LIFE INSURANCE COMPANY | $2K | $733 | $3K | 14.05% |
| OLIVIER VANDYK INSURANCE3 | 2780 44TH STREET SW WYOMING, MI 49519 | VISION SERVICE PLAN | $988 | $0 | $988 | 8.29% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD, SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $54 | — | $54 | 0.45% |
| OLIVIER VANDYK INSURANCE3 | 2780 44TH STREET SW WYOMING, MI 49519 | MUTUAL OF OMAHA INSURANCE COMPANY | $681 | $239 | $920 | 13.49% |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC. | 82 | $381K |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 82 | $27K |
| Vision | VISION SERVICE PLAN | 71 | $12K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 119 | $25K |
| Prescription drug | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC. | 82 | $381K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 119 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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.