| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUCKINGHAM INSURANCE4 | 1250 BETHLEHEM PIKE SUITE S212 HATFIELD, PA 19440 | THE UNION LABOR LIFE INSURANCE COMPANY | $31K | — | $31K | 5.00% |
| AMERICAN CORPORATE BENEFITS INC3 Filed as: AMERICAN CORPORATE BENEFITS INC. | 124 SEVEN HILLS LAKE DR. KENT LAKES, NY 10512 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $17K | — | $17K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAGNACARE ADMINISTRATIVE SRVCS LLC EIN 11-3410766 NONE | Other fees; Claims processing; Direct payment from the plan Service code 12 | — | $1.6M |
| PAYER MATRIX EIN 81-3946362 NONE | Other fees; Direct payment from the plan Service code 50 | — | $516K |
| LABOR FIRST EIN 06-1750191 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $349K |
| EXPRESS SCRIPTS, INC EIN 22-3461740 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $136K |
| CBIZ RETIREMENT PLAN SERVICES EIN 31-1582098 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $91K |
| BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Direct payment from the plan; Float revenue; Custodial (securities); Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Shareholder servicing fees Service code 19 | — | $90K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 NONE | Accounting (including auditing); Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 10 | — | $61K |
| ARCHER, BYINGTON, GLENNON & LEVINE EIN 26-0873462 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $41K |
| NATIONAL INVESTMENT SERVICES EIN 84-3937993 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $28K |
| LOOMIS SAYLES TRUST COMPANY EIN 20-8080381 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $19K |
| BERARD & ASSOCIATES, CPA'S PC EIN 13-3774222 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $7K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $7K |
| WELLINGTON TRUST COMPANY, NA EIN 04-2755549 NONE | Investment management fees paid directly by plan Service code 51 | — | $5K |
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 | 1,596 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 814 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,410 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 2,017 | $241K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,850 | $613K |
| Other | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | 2,275 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,275 | — |
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."
No prospect flags tripped on this filing.