| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| QUANTUM FINANCIAL STRATEGIES3 Filed as: QUANTUM FINANCIAL STRATEGIES IN | 118 N BEDFORD RD STE 100 MOUNT KISCO, NY 105492555 | EMBLEMHEALTH | $215K | — | $215K | 4.00% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRANT RAPIDS, MI 49503 | USABLE LIFE | $14K | — | $14K | 8.07% |
| QUANTUM FINANCIAL STRATEGIES3 Filed as: QUANTUM FINANCIAL STRATEGIES IN | 118 N BEDFORD RD STE 100 MOUNT KISCO, NY 105492555 | USABLE LIFE | $10K | — | $10K | 5.68% |
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | — | $8K | $8K | 4.59% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRANT RAPIDS, MI 49503 | SHELTERPOINT LIFE INSURANCE COMPANY | $3K | — | $3K | 2.13% |
| ACRISURE LLC | 100 OTTAWA AVE SW GRANT RAPIDS, MI 49503 | SHELTERPOINT LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMBLEM HEALTH EIN 11-1782177 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $1.1M |
| WEAVER AND TIDWELL LLP EIN 75-0786316 PROV SVCS REL ORG | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $81K |
| FUIMAN MOGILA LLP EIN 93-1652658 PROV SVCS REL ORG | Legal; Direct payment from the plan Service code 29 | — | $69K |
| AMY SLYVCHAK EIN 11-1782177 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $68K |
| CADARET GRANT EIN 22-2361254 | Investment management fees paid directly by plan; Investment management Service code 28 | 100 MADISON ST SYRACUSE, NY 13202 | $55K |
| GLADYS RODRIGUEZ EIN 11-1782177 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $52K |
| ILIANA OROZCO EIN 11-1782177 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $51K |
| MODERN ADMINISTRATION SYSTEMS, LLC EIN 92-2010862 NONE | Other fees Service code 99 | — | $36K |
| QUANTUM FINANCIAL STRATEGIES EIN 13-4017745 NONE | Consulting (general) Service code 16 | — | $33K |
| DICKINSON GROUP, LLC EIN 20-1241472 NONE | Actuarial; Consulting (general); Direct payment from the plan Service code 11 | — | $33K |
| LOOMIS SAYLES & COMPANY, L.P. EIN 04-3200030 NONE | Investment management fees paid directly by plan; Investment management; Soft dollars commissions Service code 28 | — | $9K |
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 | 1,685 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | USABLE LIFE | 951 | $170K |
| Short-term disability(2 contracts) | SHELTERPOINT LIFE INSURANCE COMPANY | 449 | $182K |
| Stop-loss / reinsurancereinsurance(2 contracts) | ZURICH AMERICAN INSURANCE COMPANY | 1,170 | $1.1M |
| Other | USABLE LIFE | 951 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,170 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.