| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARTIN KOOPER3 | 770 LEXINGTON AVE 14TH FLOOR NEW YORK, NY 10021 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $159K | — | $159K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | ONE COMMERCE SQUARE STE 820 2005 MARKET STREET PHILADELPHIA, PA 19103 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $35K | — | $35K | 1.11% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE, USE | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $585 | $585 | 0.02% |
| HARVARD PRINTING GROUP5 | C/O NEWTEK BUSINESS CREDIT PO BOX 380 WEST HEMPSTEAD, NY 11552 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $92 | $92 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2 PIERCE PL FL 14 ITASCA, IL 601431203 | RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK | $37K | — | $37K | 2.08% |
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 | 1,656 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 301 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,957 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,983 | $3.2M |
| Other | RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK | 1,983 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,983 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.