| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK, INC. | 500 PLUM STREET, SUITE 200 SYRACUSE, NY 13204 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $45K | $0 | $45K | 2.56% |
| LOCKTON COMPANIES, LLC3 | 8110 EAST UNION, SUITE 700 DENVER, CO 80237 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $23K | $0 | $23K | 1.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK, INC. | 1500 BROADWAY, 21ST FLOOR NEW YORK, NY 10036 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $3K | $0 | $3K | 0.20% |
| THE ROLLINS AGENCY INC3 Filed as: ROLLINS AGENCY INC. | 800 WESTCHESTER AVENUE, SUITE N311 RYE BROOK, NY 10573 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $34 | $0 | $34 | 0.00% |
| LOCKTON COMPANIES, LLC3 | 8110 EAST UNION, SUITE 700 DENVER, CO 80237 | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | $312 | $0 | $312 | 4.57% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK, INC. | 500 PLUM STREET, SUITE 200 SYRACUSE, NY 13204 | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | $310 | $0 | $310 | 4.54% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK, INC. | 1500 BROADWAY, 21ST FLOOR NEW YORK, NY 10036 | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | $229 | $0 | $229 | 3.35% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF VIRGINIA, INC. | PO BOX 3070 RICHMOND, VA 23228 | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | $0 | $175 | $175 | 2.56% |
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 | 191 | 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) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 375 | $1.7M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 375 | $1.7M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 375 | $1.7M |
| Life insurance | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | 191 | $7K |
| Prescription drug | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 375 | $1.7M |
| Other | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | 191 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 375 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.