| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN, INC. | 99 TROY RD. EAST GREENBUSH, NY 12061 | EXCELLUS BLUE CROSS BLUE SHIELD | $33K | — | $33K | 4.25% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN, INC. | PO BOX 640 99 TROY RD. EAST GREENBUSH, NY 12061 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $4K | $9K | 13.91% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $4K | $71 | $4K | 17.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC. EIN 43-1420563 RX CONTRACT MANAGER | Plan Administrator Service code 14 | ONE EXPRESS WAY ST. LOUIS, MO 63121 | $131K |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 108 | $784K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 131 | $63K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 131 | $63K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 131 | $63K |
| Short-term disability | AFLAC | 34 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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.