| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JN SAVASTA CORP3 Filed as: J N SAVASTA CORP. | 1350 BROADWAY SUITE 410 NEW YORK, NY 10018 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $89K | $0 | $89K | 4.06% |
| DONALD C SAVOY INC3 | 25B HANOVER RD, STE 220 FLORHAM PARK, NJ 07932 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $45K | $45K | 2.03% |
| JN SAVASTA CORP3 Filed as: J N SAVASTA CORP | 1350 BROADWAY RM 410 NEW YORK, NY 10018 | UNITED HEALTHCARE INSURANCE COMPANY | $8K | $0 | $8K | 3.88% |
| JN SAVASTA CORP3 Filed as: J N SAVASTA CORP | 1350 BROADWAY RM 410 NEW YORK, NY 10018 | FIRST RELIANCE STANDARD | $3K | $0 | $3K | 10.83% |
| JN SAVASTA CORP3 Filed as: J N SAVASTA CORP | 1350 BROADWAY RM 410 NEW YORK, NY 10018 | FIRST RELIANCE STANDARD | $2K | $0 | $2K | 10.97% |
| JN SAVASTA CORP3 Filed as: J N SAVASTA CORP | 1350 BROADWAY RM 410 NEW YORK, NY 10018 | FIRST RELIANCE STANDARD | $2K | $0 | $2K | 10.00% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP 17TH FLOOR NEW YORK, NY 10005 | FIRST RELIANCE STANDARD | $164 | $213 | $377 | 2.21% |
| JN SAVASTA CORP3 Filed as: J N SAVASTA CORP | 1350 BROADWAY RM 410 NEW YORK, NY 10018 | FIRST RELIANCE STANDARD | $358 | $0 | $358 | 15.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERICAN HEALTH DATA INSTITUTE EIN 35-2048379 | Consulting (general) Service code 16 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $0 |
| J N SAVASTA GROUP EIN 13-3553650 | Insurance agents and brokers Service code 22 | 1350 BROADWAY STE 410 NEW YORK, NY 10018 | $0 |
| KEY BENEFIT ADMINISTRATORS, INC. EIN 35-1450364 | Consulting (general) Service code 16 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $0 |
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 | 268 | 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) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 138 | $2.2M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 268 | $199K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 268 | $199K |
| Life insurance | COMPANION LIFE INSURANCE | 43 | $4K |
| Long-term disability | FIRST RELIANCE STANDARD | 113 | $17K |
| Other(3 contracts) | FIRST RELIANCE STANDARD | 99 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
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.