| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MBL BENEFITS CONSULTING CORP3 | 323 WEST 39TH STREET 11TH FLOOR NEW YORK, NY 10018 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $78K | — | $78K | 3.68% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INS SERVICES INC | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | — | $32K | $32K | 1.54% |
| UNITED STATES FINANCIAL CORPORATION3 | 4 WEST RED OAK LANE SUITE 110 WHITE PLAINS, NY 10604 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | -$205 | — | -$205 | -0.01% |
| MBL BENEFITS CONSULTING CORP3 Filed as: MBL BENEFIT CONSULTING CORP | 323 WEST 39TH STREET 11TH FLOOR NEW YORK, NY 10018 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $8K | — | $8K | 10.42% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INS SERVICES INC | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | — | $4K | $4K | 4.79% |
| MBL BENEFITS CONSULTING CORP3 Filed as: MBL BENEFITS CONSULTING, A DIVISION | LB#1803 PHILADELPHIA, PA 19195 | EYEMED VISION CARE | $2K | — | $2K | 14.84% |
| ENROLLEASE3 Filed as: ANDREW J CLARKE | 74-76 MONROE STREET APARTMENT 4 HOBOKEN, NJ 07030 | AFLAC | $976 | — | $976 | 13.16% |
| JANELLE MARIE GADOMSKI3 | 48 FAIRVIEW AVENUE PARK RIDGE, NJ 07656 | AFLAC | $280 | — | $280 | 3.78% |
| PATRICK RUHLE3 Filed as: PATRICK C HARDIE | 14 WALL STREET SUITE 8C NEW YORK, NY 10005 | AFLAC | $277 | — | $277 | 3.74% |
| ILANA A IZSAK3 | 11120 73RD AVENUE APARTMENT 9H FOREST HILLS, NY 11375 | AFLAC | $25 | — | $25 | 0.34% |
| ENROLLEASE3 Filed as: ANDREW J CLARKE | 74-76 MONROE STREET APARTMENT 4 HOBOKEN, NJ 07030 | AFLAC | $385 | $35 | $420 | 8.48% |
| JANELLE M GADOMSKI3 | 48 FAIRVIEW AVENUE PARK RIDGE, NJ 07656 | AFLAC | $198 | $8 | $206 | 4.16% |
| PATRICK RUHLE3 Filed as: PATRICK C HARDIE | 14 WALL STREET SUITE 8C NEW YORK, NY 10005 | AFLAC | $104 | $8 | $112 | 2.26% |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 172 | $2.1M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 172 | $2.1M |
| Vision | EYEMED VISION CARE | 286 | $15K |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 199 | $75K |
| Short-term disability(3 contracts, 2 carriers) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 199 | $87K |
| Long-term disability | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 199 | $75K |
| Other(3 contracts, 2 carriers) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 199 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 286 | — |
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.