| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $4K | $2K | $6K | 13.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $3K | $954 | $3K | 13.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $2K | $886 | $3K | 13.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $2K | $715 | $3K | 13.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $314 | $103 | $417 | 13.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $184 | $69 | $253 | 13.74% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | — | FEDERAL INSURANCE COMPANY | $349 | — | $349 | 19.99% |
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 | 195 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | CIGNA LIFE INSURANCE CO. OF NEW YORK | 194 | $44K |
| Short-term disability(2 contracts) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 162 | $42K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 195 | $25K |
| Stop-loss / reinsurancereinsurance | CIGNA LIFE INSURANCE CO. OF NEW YORK | 33 | $3K |
| Other(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 195 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.