| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADIRONDACK TRUST COMPANY3 Filed as: ADIRONDACK TRUST INSURANCE AGENCY | PO BOX 336 SARATOGA SPRINGS, NY 12866 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $98K | — | $98K | 3.24% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INS SERVICES INC | 1000 WOODBURY RD SUITE 403 WOODBURY, NY 117972530 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $2K | $5K | 13.72% |
| ADIRONDACK TRUST COMPANY3 Filed as: ADIRONDACK TRUST CO FINANCIAL SERV | 31 CHURCH STREET 4TH FL SARATOGA SPRINGS, NY 12866 | EMPIRE HEALTH CHOICE ASSURANCE, INC. (G1921) | $866 | — | $866 | 4.23% |
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 | 500 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 505 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | 520 | $3.0M |
| Vision | EMPIRE HEALTH CHOICE ASSURANCE, INC. (G1921) | 360 | $20K |
| Life insurance | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 458 | $35K |
| Prescription drug | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | 520 | $3.0M |
| Other | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 458 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 520 | — |
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.
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.