| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PRES WHITE AGENCY INC.4 Filed as: PRES WHITE AGENCY INC | 76 NORTH BROADWAY IRVINGTON, NY 105331238 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 4.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 06-0303370 NONE | Other services; Direct payment from the plan; Contract Administrator; Participant communication; Float revenue; Named fiduciary; Non-monetary compensation; Claims processing Service code 12 | — | $800K |
| MAXON COMPANY EIN 13-2611019 NONE | Actuarial; Contract Administrator; Direct payment from the plan; Claims processing Service code 11 | — | $482K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $455K |
| BARBARA FEDUMENTI EIN 06-6069081 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $128K |
| SLEVIN & HART, P.C. NONE | Legal; Direct payment from the plan Service code 29 | 1625 MASSACHUSETTS AVE. NW WASHINGTON, DC 20036 | $98K |
| PATRICIA LAZZARA EIN 06-6069081 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $88K |
| KATIE WILKINSON EIN 34-9506680 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| JAMIE GARNETT EIN 06-6069081 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $78K |
| CHRISTOPHER LEE EIN 06-6069081 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $74K |
| RIVKIN RADLER LLP EIN 11-1853927 NONE | Legal; Direct payment from the plan Service code 29 | — | $69K |
| ROSE MARIE ARLIO EIN 06-6069081 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| THOMAS WILKINSON EIN 06-6069081 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| TAB COMPUTER SYSTEMS EIN 06-1297933 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $55K |
| PREMIER TECHNOLOGY SOLUTIONS, INC. NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 232 MADISON AVE. 15 NEW YORK, NY 10016 | $53K |
| SEMO LAW GROUP NONE | Legal; Direct payment from the plan Service code 29 | 1800 M STREET 730S WASHINGTON, DC 20036 | $30K |
| UBS FINANCIAL SERVICES EIN 13-2638166 NONE | Direct payment from the plan; Other fees; Investment advisory (plan) Service code 27 | — | $30K |
| SECOVA, INC. NONE | Claims processing; Employee (plan) Service code 12 | 1800 NJ 34 301 WALL TOWNSHIP, NJ 07719 | $29K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 3000 S. LENOLA RD. MAPLE SHADE, NJ 08052 | $19K |
| FIRST AMERICAN ADMINISTRATORS EIN 86-0773195 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $16K |
| ALLIANCE BERNSTEIN EIN 13-4064930 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $13K |
| ADP EIN 22-1467904 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 4,717 | $79K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 4,717 | $79K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 4,717 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,717 | — |
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."
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.