| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC | 50 WHITECAP DR NORTH KINGSTOWN, RI 02852 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $0 | $7K | $7K | 6.09% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC | 50 WHITECAP DR NORTH KINGSTOWN, RI 02852 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $0 | $7K | $7K | 7.62% |
| ROSE & KIERNAN INC3 | 99 TROY RD E GREENBUSH, NY 120611027 | AMERITAS LIFE INSURANCE CORP. OF NEW YORK | $3K | $0 | $3K | 3.65% |
| ROSE & KIERNAN INC3 | 99 TROY RD E GREENBUSH, NY 120611027 | MVP HEALTHCARE | $2K | $0 | $2K | 4.09% |
| ROSE & KIERNAN INC3 | 99 TROY RD E GREENBUSH, NY 120611027 | MVP HEALTHCARE | $2K | $0 | $2K | 4.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CHEIRON INC. EIN 03-4215617 CONSULTANT | Consulting (general); Actuarial Service code 11 | 8300 GREENSBORO DRIVE SUITE 800 TYSONS CORNER, VA 22102 | $29K |
| OPTUM CONNECTYOURCARE NONE | Custodial (other than securities) Service code 18 | 307 INTERNATIONAL CIRCLE HUNT VALLEY, MD 21030 | $11K |
| CIGNA DENTAL SERVICE PROVIDER | Plan Administrator; Claims processing; Insurance services Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $10K |
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 | 509 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 511 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC | 1,042 | $363K |
| Vision | AMERITAS LIFE INSURANCE CORP. OF NEW YORK | 1,249 | $81K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 838 | $89K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 838 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,249 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.