| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 16805 W CLEVELAND AVENUE NEW BERLIN, WI 53151 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $68K | $408 | $68K | 4.31% |
| TEPANI INC3 | 50 BROADWAY HAWTHORNE, NY 10532 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $0 | $26K | $26K | 1.65% |
| GA SOLUTIONS LLC3 | 65 MECHANIC STREET SUITE 106 RED BANK, NJ 07701 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $683 | $6K | 19.67% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 113 | $1.6M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 113 | $1.6M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 113 | $1.6M |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $31K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $31K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.