| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ULSTER INSURANCE SERVICES, INC. Filed as: ULSTER INSURANCE SERVICES | P.O. BOX 3995 KINGSTON, NY 12402 | DELTA DENTAL OF NEW YORK | $4K | — | $4K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK INC | 333 EARLE OVINGTON BLVD STE 215 UNIONDALE, NY 115533610 | COMPANION LIFE INSURANCE COMPANY | $2K | $244 | $2K | 16.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK INC | 333 EARLE OVINGTON BLVD STE 215 UNIONDALE, NY 115533610 | MUTUAL OF OMAHA INSURANCE COMPANY | $103 | $12 | $115 | 16.74% |
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 | 78 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 82 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTH CARE | 218 | $1.2M |
| Dental | DELTA DENTAL OF NEW YORK | 218 | $79K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 103 | $14K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 73 | $687 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.