| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN KLIMCHAK3 | CSZ MELVILLE, NY 11747 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY | $4K | — | $4K | 8.11% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PARKWAY VEVA-16, SUITE 320 BLUE BELL, PA 19422 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| BENEFITS EVALUATION GROUP INC3 Filed as: THE BENEFITS EVALUATION GROUP INC | 535 BROADHOLLOW ROAD SUITE A3A MELVILLE, NY 117473700 | AMERITAS LIFE INSURANCE CORP OF NEW YORK | $2K | — | $2K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT ADMINISTRATIVE SYSTEMS, LLC EIN 36-4197088 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 17475 JOVANNA DRIVE HOMEWOOD, IL 60430 | $138K |
| CIGNA EIN 35-2029627 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 11595 N MERIDIAN ST CARMEL, IN 46032 | $60K |
| VSP/EYEMED EIN 06-1227840 INSURER | Insurance services Service code 23 | 16850 SATURN LANE HOUSTON, TX 77058 | $51K |
| EQUITABLE LIFE INS COMP EIN 58-5512450 INSURER | Insurance services Service code 23 | 1290 AVENUE OF THE AMERICAS NEW YORK, NY 10104 | $49K |
| AMERITAS LIFE INC. CORP OF NY EIN 13-3758127 INSURER | Insurance services Service code 23 | 1350 BROADWAY SUITE 1710 NEW YORK, NY 10018 | $46K |
| TELADOC EIN 04-3705970 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 17304 PRESTON RAD DALLAS, TX 75252 | $11K |
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 | 607 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 609 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AMERITAS LIFE INSURANCE CORP OF NEW YORK | 1,421 | $46K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY | 565 | $50K |
| Stop-loss / reinsurancereinsurance | CIGNA | 423 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,421 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.