| 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 | $5K | — | $5K | 10.00% |
| 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 | — | $3K | 10.80% |
| 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 | — | $2K | 9.30% |
| 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 | — | $2K | 10.00% |
| 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 | $332 | — | $332 | 9.25% |
| 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 | $190 | — | $190 | 9.21% |
| 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 | 175 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | CIGNA LIFE INSURANCE CO. OF NEW YORK | 175 | $48K |
| Short-term disability(3 contracts) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 149 | $50K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 175 | $28K |
| Other(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 186 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.