| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 320 WEST 57TH STREET NEW YORK, NY 10019 | HCC LIFE INSURANCE COMPANY | $37K | — | $37K | 15.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 320 WEST 57TH STREET NEW YORK, NY 10019 | DELTA DENTAL OF NEW YORK | $6K | — | $6K | 3.38% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT ISNURANCE SERVICES INC | 320 WEST 57TH ST NEW YORK, NY 10019 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $10K | $1K | $11K | 11.28% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 320 WEST 57TH STREET NEW YORK, NY 10019 | UNITED HEALTHCARE INSURANCE COMPANY OF NY | $1K | — | $1K | 10.15% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES | 1655 RICHMOND AVE STATEN ISLAND, NY 10314 | HARTFORD LIFE INSURANCE | $473 | — | $473 | 16.99% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT | 320 WEST 57TH STREET NEW YORK, NY 10019 | HARTFORD LIFE INSURANCE | $418 | — | $418 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGER | Other fees; Float revenue; Claims processing; Direct payment from the plan Service code 12 | — | $425K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $134K |
| ALLIANT INSURANCE SERVICES INC EIN 33-0785439 BROKER | Other commissions Service code 55 | — | $24K |
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 | 225 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW YORK | 306 | $178K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY OF NY | 153 | $15K |
| Life insurance | CIGNA LIFE INSURANCE CO. OF NEW YORK | 225 | $101K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 225 | $101K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 203 | $245K |
| Other(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 225 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 306 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.