| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PETER DERRENBACKER3 Filed as: PETER L DERRENBACKER | 34 ASPEN PARK BLVD EAST SYRACUSE, NY 13057 | HARTFORD LIFE AND ACCIDENT | $25K | $0 | $25K | 10.73% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES LLC | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | HARTFORD LIFE AND ACCIDENT | $0 | $12K | $12K | 5.37% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES LLC | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 1.20% |
| PETER DERRENBACKER3 Filed as: PETER L DERRENBACKER | 34 ASPEN PARK BLVD EAST SYRACUSE, NY 13057 | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | $8K | $0 | $8K | 7.00% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES | 1933 STATE ROUTE 35 SUITE 368 WALL TOWNSHIP, NJ 07719 | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | $5K | $0 | $5K | 5.00% |
| MGIS3 | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 841112176 | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | $0 | $195 | $195 | 0.18% |
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 | 599 | 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) | 599 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | 598 | $108K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 599 | $230K |
| Other | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | 598 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 599 | — |
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.