| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 370 OLD COUNTRY ROAD GARDEN CITY, NY 11530 | MUTUAL OF OMAHA | $334 | $26 | $360 | 3.94% |
| ACRISURE LLC3 | 370 OLD COUNTRY ROAD GARDEN CITY, NY 11530 | MUTUAL OF OMAHA | $202 | $22 | $224 | 2.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DANIEL H COOK ASSOCIATES, INC. EIN 11-2424843 THIRD PARTY ADMINISTRATOR | Plan Administrator; Direct payment from the plan; Contract Administrator Service code 13 | 253 WEST 35TH STREET NEW YORK, NY 10001 | $282K |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Direct payment from the plan; Contract Administrator Service code 13 | 450 COLUMBUS BOULEVARD HARTFORD, CT 061150450 | $91K |
| JAMES R GRISI PC EIN 83-2921602 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 199 NO. WELLWOOD AVENUE LINDENHURST, NY 11757 | $78K |
| RHINA MATA EIN 11-2548572 ADMINISTRATOR | Employee (plan); Direct payment from the plan Service code 30 | 800 SUNRISE HIGHWAY WEST BABYLON, NY 11704 | $62K |
| TIAA, FSB EIN 59-3531592 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management Service code 28 | 211 NORTH BROADWAY ST LOUIS, MO 63102 | $48K |
| GETTRY MARCUS CPA, P.C. EIN 13-3418879 | Direct payment from the plan; Accounting (including auditing) Service code 10 | 88 FROEHLICH BLVD, 3RD FLOOR WOODBURY, NY 11797 | $39K |
| SELEDENT, INC EIN 11-3310187 CLAIMS PROCESSOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Claims processing Service code 12 | ONE HUNTINGTON QUADRANGLE MELVILLE, NY 11747 | $25K |
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 | 819 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 819 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Long-term disability | MUTUAL OF OMAHA | 8 | $9K |
| Other | MUTUAL OF OMAHA | 283 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.