| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MPL LLC3 | 14 BUSINESS PARK DRIVE #8 BRANFORD, CT 06405 | STANDARD INSURANCE COMPANY | $726 | — | $726 | 0.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRI STATE JOINT FUND EIN 06-0850110 AFFILIATED ORGANIZATION | Direct payment from the plan; Legal; Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing; Actuarial Service code 10 | — | $392K |
| ANTHEM BLUE CROSS BLUE SHIELD EIN 06-1475928 NONE | Contract Administrator; Claims processing; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $230K |
| PREFERRED ACCESS NETWORK EIN 36-4018433 NONE | Other fees; Other services Service code 49 | — | $82K |
| CLAIMS PROCESSOR EIN 04-2589472 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $76K |
| FUND MANAGER EIN 04-2589472 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $75K |
| MANNING & NAPIER ADVISORS, INC EIN 45-3240790 NONE | Investment management; Investment management fees paid indirectly by plan; Investment management fees paid directly by plan Service code 28 | 290 WOODCLIFF DRIVE FAIRPORT, NY 14450 | $42K |
| RAYMOND JAMES ASSOCIATES INC EIN 59-1237041 NONE | Other investment fees and expenses; Other fees; Investment advisory (plan); Custodial (securities); Account maintenance fees; Investment management fees paid directly by plan Service code 19 | — | $40K |
| VALENZ HEALTH EIN 52-1169362 NONE | Other services; Other fees Service code 49 | — | $32K |
| DHK FINANCIAL ADVISORS INC EIN 02-0464577 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $30K |
| ADMINISTRATIVE STAFF EIN 04-2589472 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $26K |
| UPRISE HEALTH EIN 35-1955872 NONE | Other services; Other fees Service code 49 | — | $23K |
| LARRY KEEFE EIN 04-2589472 EMPLOYER TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $17K |
| ROBERT SULLIVAN EIN 04-2589472 EMPLOYER TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $17K |
| FRANK ROSSI EIN 04-2589472 UNION TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $17K |
| ALLEGIANT RX EIN 02-6015031 NONE | Contract Administrator; Consulting (general); Other fees Service code 13 | 91 GOFFSTOWN ROAD MANCHESTER, NH 03102 | $11K |
| OPTUM RX EIN 33-0441200 NONE | Claims processing; Other fees; Other services Service code 12 | — | $6K |
| BJ DONOVAN EIN 04-2589472 UNION TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $5K |
| MPL LLC EIN 06-1537302 NONE | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | — | $0 |
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 | 586 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 68 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 546 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | STANDARD INSURANCE COMPANY | 586 | $85K |
| Other | STANDARD INSURANCE COMPANY | 586 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 586 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.