| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES P. REAGAN AGENCY, INC.3 Filed as: JAMES P REAGAN AGENCY | 8 E. MAIN ST MARCELLUS, NY 13108 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $4K | $0 | $4K | 3.68% |
| JAMES P. REAGAN AGENCY, INC.3 Filed as: JAMES P REAGAN AGENCY | 8 E. MAIN ST MARCELLUS, NY 13108 | ANTHEM LIFE & DISABILITY INSURANCE | $2K | $0 | $2K | 15.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM INC EIN 33-0441200 PHARMACY BENEFIT MANAGER | Float revenue; Direct payment from the plan; Other fees; Claims processing Service code 12 | 2300 MAIN ST IRVINE, CA 92614 | $125K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 150 W WAUSAU AVE WAUSA, WI 54401 | $41K |
| JAMES P REAGAN AGENCY EIN 16-1150253 BROKER | Other commissions Service code 55 | 8 E MAIN ST MARCELLUS, NY 13108 | $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 | 217 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 135 | $100K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 135 | $100K |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE | 217 | $16K |
| Other | ANTHEM LIFE & DISABILITY INSURANCE | 217 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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.