| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WIB BROKERS INC.3 | 1133 WESTCHESTER AVENUE SUITE 229 WHITE PLAINS, NY 10604 | UNITED HEALTHCARE INSURANCE COMPANY | $14K | — | $14K | 4.00% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. & FINANCIAL SVCS. | 1133 WESTCHESTER AVENUE SUITE S229 WHITE PLAINS, NY 10604 | DELTA DENTAL OF NJ INC. | $7K | — | $7K | 3.79% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | 90 KREIGER LANE P.O. BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INS. CO. | $9K | — | $9K | 13.74% |
| WIB BROKERS INC.3 | 1133 WESTCHESTER AVENUE SUITE S 229 WHITE PLAINS, NY 06033 | PROVIDENT LIFE AND ACCIDENT INS. CO. | $2K | — | $2K | 2.72% |
| WIB BROKERS INC.3 | 1133 WESTCHESTER AVENUE S-229 WHITE PLAINS, NY 10604 | PROVIDENT LIFE AND ACCIDENT INS. CO. | $408 | — | $408 | 0.61% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FIN SVCS | 1133 WESTCHESTER AVENUE SUITE 229 WHITE PLAINS, NY 10604 | UNION SECURITY INSURANCE COMPANY | $5K | $3K | $8K | 12.50% |
| PETER WALDOR & ASSOCIATES LLC3 | 220 SOUTH ORANGE AVENUE SUITE 200 LIVINGSTON, NY 07039 | UNION SECURITY INSURANCE COMPANY | $5K | — | $5K | 7.50% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | 90 KREIGER LANE P.O. BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | $2K | $24K | 38.21% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FNCL SVCS | 1133 WESTCHESTER AVENUE SUITE S 229 WHITE PLAINS, NY 10604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $98 | $6K | 9.04% |
| WIB BROKERS INC.3 | 1133 WESTCHESTER AVENUE SUITE S229 WHITE PLAINS, NY 10604 | UNUM LIFE INS. CO. OF AMERICA | $9K | — | $9K | 19.99% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. & FNCL SVCS | 1133 WESTCHESTER AVENUE S-229 WHITE PLAINS, NY 10604 | UNUM LIFE INS. CO. OF AMERICA | — | $545 | $545 | 1.25% |
| WIB BROKERS INC.3 | 1133 WESTCHESTER AVENUE SUITE S229 WHITE PLAINS, NY 10604 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 9.19% |
| DKG INS & FINANCIAL SERV INC.3 Filed as: DKG INS. & FINANCIAL SVCS. | 1133 WESTCHESTER AVENUE SUITE S229 WHITE PLAINS, NY 10604 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 15.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS ADMINISTRATOR | Claims processing; Other services Service code 12 | P.O. BOX 1459 MINNEAPOLIS, MN 55440 | $216K |
| WIB BROKERS INC. EIN 06-1345781 BROKER | Other commissions Service code 55 | 1133 WESTCHESTER AVENUE SUITE S 229 WHITE PLAINS, NY 10604 | $0 |
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 | 249 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 191 | $349K |
| Dental | DELTA DENTAL OF NJ INC. | 285 | $197K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 191 | $12K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INS. CO. OF AMERICA | 367 | $54K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INS. CO. | 304 | $67K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 153 | $67K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 367 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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.