| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING INC | 100 MAIN STREET POUGHKEEPSIE, NY 12601 | AETNA LIFE INSURANCE COMPANY | $11K | — | $11K | 6.36% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES INC. | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | AETNA LIFE INSURANCE COMPANY | $4K | — | $4K | 2.12% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING INC | 110 MAIN STREET POUGHKEEPSIE, NY 126016707 | COMPANION LIFE INSURANCE COMPANY | $6K | — | $6K | 13.13% |
| NAVERA, INC3 Filed as: NAVERA, INC. | 101 MONTGOMERY ST., SUITE 350 SAN FRANCISCO, CA 941044175 | COMPANION LIFE INSURANCE COMPANY | $3K | — | $3K | 7.39% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | SIX TOWER PLAZA NEW YORK, NY 122033725 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 4.48% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING INC | 110 MAIN STREET POUGHKEEPSIE, NY 126016707 | MUTUAL OF OMAHA INSURANCE COMPANY | $4K | — | $4K | 10.65% |
| NAVERA, INC3 | 101 MONTGOMERY ST STE 350 SAN FRANCISCO, CA 941044175 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | — | $3K | 5.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK, INC. | SIX TOWER PLACE ALBANY, NY 122033725 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | — | $1K | 3.37% |
| GREATER METRO AGENCY INC3 Filed as: GREATER METRO AGENCY | 2003 JERICHO TURNPIKE #1 NEW HYDE PARK, NY 11040 | EYEMED VISION CARE | $2K | — | $2K | 4.78% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | SIX TOWER PLACE ALBANY, NY 12203 | EYEMED VISION CARE | $936 | — | $936 | 2.87% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING INC | 110 MAIN ST POUGHKEEPSIE, NY 12601 | MUTUAL OF OMAHA INSURANCE COMPANY | $4K | — | $4K | 13.27% |
| NAVERA, INC3 | 101 MONTGOMERY ST STE 350 SAN FRANCISCO, CA 941044175 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | — | $2K | 7.46% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK, INC. | SIX TOWER PLACE ALBANY, NY 122033725 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | — | $1K | 4.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PARADIGM EIN 45-3581579 | Contract Administrator Service code 13 | 300 MAIN STREET LAFAYETTE, IN 47902 | $142K |
| BAS EIN 36-4197088 | Claims processing Service code 12 | 17475 JOVANNA DRIVE HOMEWOOD, IL 60430 | $66K |
| AMERICAN HEALTH HOLDINGS, INC. EIN 31-1368946 | Other fees Service code 99 | 100 WEST OLD WILSON BRIDGE RD WORTHINGTON, OH 43085 | $7K |
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 | 720 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 720 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 720 | $165K |
| Vision | EYEMED VISION CARE | 475 | $33K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 172 | $46K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 100 | $42K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 84 | $31K |
| Stop-loss / reinsurancereinsurance | NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURGH | 476 | $340K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 720 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.