| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONALD C SAVOY INC3 Filed as: DONALD C. SAVOY, INC. | 25B HANOVER ROAD SUITE 220 FLORHAM PARK, NJ 07932 | OXFORD HEALTH INSURANCE, INC | — | $9K | $9K | 1.99% |
| SGFI INSURANCE BROKERAGE INC.3 | 261 MADISON AVENUE 5TH FLOOR NEW YORK, NY 10016 | OXFORD HEALTH INSURANCE, INC | $8K | — | $8K | 1.89% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-GFI | 261 MADISON AVENUE 6TH FLOOR NEW YORK, NY 10016 | OXFORD HEALTH INSURANCE, INC | $5K | — | $5K | 1.04% |
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 | 132 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OXFORD HEALTH INSURANCE, INC | 132 | $448K |
| Prescription drug | OXFORD HEALTH INSURANCE, INC | 132 | $448K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.