| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE AGENCY, INC. | 1 EMPIRE DRIVE RENSSELAER, NY 12144 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $49K | $49K | 1.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $49K | $49K | 1.92% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE AGENCY, INC. | 1 EMPIRE DRIVE RENSSELAER, NY 12144 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | $0 | $3K | 2.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | $0 | $3K | 2.64% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE AGENCY, INC. | ONE EMPIRE DRIVE RENSSELAER, NY 12144 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | $0 | $5K | 4.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 784 TROY SCHENECTADY ROAD LATHAM, NY 12210 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | $0 | $5K | 4.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $678 | $678 | 0.57% |
| NEESENROLL3 | 65 BURBANK ROAD SUTTON, MA 01590 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | $0 | $2K | 16.02% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE AGENCY, INC. | ONE EMPIRE DRIVE RENSSELAER, NY 12144 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $950 | $0 | $950 | 7.02% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | VISION SERVICE PLAN | $226 | $0 | $226 | 3.34% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 237 | $2.5M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 324 | $163K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 192 | $134K |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 412 | $171K |
| Short-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 412 | $171K |
| Long-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 412 | $171K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 237 | $2.5M |
| Other(5 contracts, 5 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 579 | $229K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 579 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.