| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNION BENEFIT PLANNERS,3 | 34 JAROMBEK DRIVE TOWACO, NJ 07082 | HARTFORD LIFE AND ACCIDENT | $12K | — | $12K | 10.03% |
| UNION BENEFIT PLANNERS,3 | 181 NEW R, STE 204 PARSIPPANY, NJ 07054 | COMPANION LIFE INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| UNION BENEFIT PLANNERS,3 | 181 NEW R, STE 204 PARSIPPANY, NJ 07054 | MUTUAL OF OMAHA INSURANCE COMPANY | $719 | — | $719 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS BLUE SHIELD EIN 23-7391136 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $460K |
| N. QUINN EIN 11-2159859 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $94K |
| V. CORDATO EIN 11-2159859 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Direct payment from the plan Service code 15 | — | $79K |
| S. PINZON EIN 11-2159859 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $68K |
| MORGAN,LEWIS,BOCKIUS EIN 23-0891050 NONE | Legal; Direct payment from the plan Service code 29 | — | $67K |
| LOCAL 707 IBT EIN 13-5559086 RELATED PARTY | Other services; Direct payment from the plan Service code 49 | — | $58K |
| J. MUNOZ EIN 11-2159859 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $57K |
| FABRICANT & FABRICANT INC EIN 13-1942233 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $55K |
| T. TINERVIA EIN 11-2159859 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $51K |
| J. KIMMERLING EIN 11-2159859 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| S.A KOENIG & ASSOCIATES, CPA'S EIN 11-3141654 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $49K |
| EXPRESS SCRIPTS EIN 22-2230703 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $45K |
| O'SULLIVAN ASSOCIATES EIN 20-8199367 NONE | Actuarial; Consulting (general); Direct payment from the plan Service code 11 | — | $43K |
| ALICARE MEDICAL MANAGEMENT EIN 13-3860528 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $42K |
| R. ROSSI EIN 11-2159859 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $38K |
| D.D SERVICES,INC. EIN 11-2705347 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $37K |
| UBS INSTITUTIONAL CONSULTING EIN 13-2638166 NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | — | $25K |
| CARLOS ANNESE, M.D EIN 11-2632850 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $25K |
| TEAMSTER CENTER SERVICES FUND EIN 13-1964856 NONE | Direct payment from the plan; Other services Service code 49 | — | $24K |
| CARY KANE, LLP EIN 20-1942442 NONE | Legal; Direct payment from the plan Service code 29 | — | $20K |
| BANK OF NEW YORK EIN 13-5160382 NONE | Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $19K |
| DAISY SINGH NONE | Direct payment from the plan; Consulting (general) Service code 16 | 87-40 SANTIAGO STREET HOLLISWOOD, NY 11423 | $16K |
| BOYD WATTERSON EIN 34-1922005 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $7K |
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 | 1,001 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 37 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,038 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 1,045 | $82K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 854 | $115K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 762 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,045 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.