| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEWYORK INC | 1133 WESTCHESTER AVENUE SUITE N136 WEST HARRISON, NY 10604 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $73K | $3K | $76K | 2.82% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGY OF VA INC | 11220 ASSET LOOP SUITE 104 MANASSAS, VA 20109 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | — | $103 | $103 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEWYORK INC | 1133 WESTCHESTER AVENUE SUITE N136 WEST HARRISON, NY 10604 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $6K | — | $6K | 11.61% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGY OF VA INC | 11220 ASSET LOOP SUITE 104 MANASSAS, VA 20109 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | — | $500 | $500 | 0.91% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY INC | 15000 BROADWAY 21ST FLOOR NEW YORK, NY 10036 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY INC | 1500 BROADWAY 21ST FLOOR NEW YORK, NY 10036 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $130 | — | $130 | 0.65% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 227 | $2.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 185 | $20K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 227 | $2.7M |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 140 | $55K |
| Short-term disability(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 185 | $62K |
| Long-term disability | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 140 | $55K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 185 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 227 | — |
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.