| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONALD C SAVOY INC3 | 25B HANOVER RD SUITE 220 FLORHAM PARK, NJ 07932 | EMPIRE HEALTHCHOICE ASSURANCE,INC. | $18K | $0 | $18K | 1.93% |
| CORPORATE HEALTH INNOVATIONS3 | 1375 BRODWAY 6TH FLOOR NEW YORK, NY 10018 | EMPIRE HEALTHCHOICE ASSURANCE,INC. | $13K | $0 | $13K | 1.45% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 1133 WESTCHESTER AVE STE S229 WHITE PLAINS, NY 10604 | EMPIRE HEALTHCHOICE ASSURANCE,INC. | $9K | $0 | $9K | 1.02% |
| EDWARD P LEVINS3 | 1375 BRODWAY 6TH FLOOR NEW YORK, NY 10018 | EMPIRE HEALTHCHOICE ASSURANCE,INC. | $2K | $0 | $2K | 0.17% |
| DONALD C SAVOY INC3 | 25B HANOVER RD SUITE 220 FLORHAM PARK, NJ 07932 | EMPIRE HEALTHCHOICE ASSURANCE,INC. | $260 | $0 | $260 | 0.03% |
| CORPORATE HEALTH INNOVATIONS3 | 1375 BRODWAY 6TH FLOOR NEW YORK, NY 10018 | EMPIRE HEALTHCHOICE ASSURANCE,INC. | $184 | $0 | $184 | 0.02% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 1133 WESTCHESTER AVE STE S229 WHITE PLAIN, NY 10604 | EMPIRE HEALTHCHOICE ASSURANCE,INC. | $85 | $0 | $85 | 0.01% |
| EDWARD P LEVINS3 | 1375 BRODWAY 6TH FLOOR NEW YORK, NY 10018 | EMPIRE HEALTHCHOICE ASSURANCE,INC. | $23 | $0 | $23 | 0.00% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 1133 WESTCHESTER AVE STE S229 WHITE PLAINS, NY 10604 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 3.70% |
| KEVIN GARVIN3 Filed as: KEVIN V GARVIN | 6 CRICKLEWOOD LANE NORWALK, CT 06851 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $935 | — | $935 | 1.30% |
| TOBIN WHITMAN3 | 149 BROAD BROOK ROAD BEDFORD HILLS, NY 10507 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $935 | — | $935 | 1.30% |
| ANDREW G ROMANO3 | 700 GROVE STREET 2N JERSEY CITY, NJ 07310 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $467 | — | $467 | 0.65% |
| GARVIN GROUP LTD THE3 | 6 CRICKLEWOOD LANE NORWALK, CT 06851 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $302 | $302 | 0.42% |
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 | 204 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE,INC. | 204 | $923K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 185 | $72K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE,INC. | 204 | $923K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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.