| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSURED SKCG | 123 MAIN STREET 14TH FLOOR WHITE PLAINS, NY 10601 | FAIR AMERICAN INSURANCE AND REINSURANCE CO. | $86K | — | $86K | 14.06% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 90 BROAD STREET SUITE 801 NEW YORK, NY 10004 | FAIR AMERICAN INSURANCE AND REINSURANCE CO. | $9K | — | $9K | 1.51% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NORTHEAST, LLC | 1300 WINSTED ROAD TORRINGTON, CT 06790 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | $8K | $22K | 9.99% |
| NMP PLANNING CO. INC3 Filed as: NMP PLANNING COMPANY, INC. | 11835 QUEENS BOULEVARD FOREST HILLS, NY 11375 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $545 | — | $545 | 0.25% |
| NEW YORK ROSBRUCH AND HARNIK3 Filed as: NEW YORK ROSBRUCH AND HARNIK INC. | 1025 WESTCHESTER AVE WHITE PLAINS, NY 10604 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $103 | — | $103 | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFIT SYSTEMS, INC. EIN 36-3086057 NONE | Claims processing; Contract Administrator Service code 12 | — | $42K |
| ASSURED SKCG EIN 45-3443572 NONE | Claims processing; Contract Administrator Service code 12 | — | $33K |
| CIGNA EIN 59-1031071 NONE | Contract Administrator; Claims processing Service code 12 | — | $19K |
| PROFESSIONAL GROUP PLANS, INC. EIN 11-3144545 NONE | Contract Administrator; Claims processing Service code 12 | — | $8K |
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FAIR AMERICAN INSURANCE AND REINSURANCE CO. | 109 | $612K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $221K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $221K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $221K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $221K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $221K |
| Stop-loss / reinsurancereinsurance | FAIR AMERICAN INSURANCE AND REINSURANCE CO. | 109 | $612K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.