| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 370 OLD COUNTRY ROAD GARDEN CITY, NY 11530 | COMPANION LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| ACRISURE LLC4 | 370 OLD COUNTRY ROAD GARDEN CITY, NY 11530 | COMPANION LIFE INSURANCE COMPANY | $616 | $98 | $714 | 11.60% |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT LTD | 12006 RIDGEMONT RD URBANDALE, IA 50323 | COMPANION LIFE INSURANCE COMPANY | $0 | $308 | $308 | 5.00% |
| ACRISURE LLC3 | 370 OLD COUNTRY ROAD GARDEN CITY, NY 11530 | MUTUAL OF OMAHA | $339 | $0 | $339 | 15.01% |
| ACRISURE LLC3 | 370 OLD COUNTRY ROAD GARDEN CITY, NY 11530 | MUTUAL OF OMAHA | $62 | $10 | $72 | 11.69% |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT LTD | 12006 RIDGEMONT RD URBANDALE, IA 50323 | MUTUAL OF OMAHA | $0 | $31 | $31 | 5.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DANIEL H COOK ASSOCIATES, INC. EIN 11-2424843 THIRD PARTY ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Plan Administrator Service code 13 | 253 WEST 35TH STREET NEW YORK, NY 10001 | $330K |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Contract Administrator; Direct payment from the plan Service code 13 | 450 COLUMBUS BOULEVARD HARTFORD, CT 061150450 | $122K |
| JAMES R GRISI PC EIN 83-2921602 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 800 SUNRISE HIGHWAY WEST BABYLON, NY 11704 | $80K |
| JENNIFER FARRUGIA EIN 11-2548572 ADMINISTRATOR | Employee (plan); Direct payment from the plan Service code 30 | 88 FROEHLICH BLVD, 3RD FLOOR WEST BABYLON, NY 11704 | $60K |
| RHINA MATA EIN 11-2548572 ADMINISTRATOR | Employee (plan); Direct payment from the plan Service code 30 | 199 N. WELLCOOD AVENUEQ LINDENHURST, NY 11757 | $57K |
| EMPIRX EIN 47-1226691 CLAIMS PROCESSOR | Claims processing; Direct payment from the plan Service code 12 | 155 CHESTNUT RIDGE ROAD MONTVALE, NJ 07645 | $49K |
| TIAA, FSB EIN 59-3531592 INVESTMENT MANAGER | Investment management; Investment management fees paid directly by plan Service code 28 | 211 NORTH BROADWAY ST LOUIS, MO 63102 | $45K |
| 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 | $45K |
| SELE-DENT INC. EIN 11-3310187 CLAIMS PROCESSOR | Claims processing; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | ONE HUNTINGTON QUADRANGLE STE 1S03 MELVILLE, NY 11747 | $25K |
| PEAK RETIREMENT GROUP LLC EIN 13-3859124 CONSULTANT | Direct payment from the plan; Consulting (general) Service code 16 | 2870 HEMSTEAD TURNPIKE, SUITE 102 LEVITTOWN, NY 11756 | $18K |
| TIMOTHY R. HOTT, ESQ. EIN 22-3724341 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 26910 GRAND CTRL. PKWY - APT 11A FLORAL PARK, NY 11005 | $6K |
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 | 653 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 653 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Long-term disability | MUTUAL OF OMAHA | 8 | $2K |
| Other(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 176 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.