| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 9500 S DADELAND BLVD MIAMI, FL 33156 | DENTCARE DELIVERY SYSTEMS | $73K | — | $73K | 9.99% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DR CENTER II STE 305 ELMWOOD PARK, NJ 07407 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $31K | $31K | 18.91% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $3K | — | $3K | 1.55% |
| ACRISURE LLC3 Filed as: ACRISURE GREAT LAKES PTR INS SVCS | 223 W GRAND AVE 1 HOWELL, MI 48843 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $229 | — | $229 | 0.14% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DR CENTER II STE 305 ELMWOOD PARK, NJ 07407 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $5K | $5K | 10.93% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | — | $2K | 4.91% |
| ACRISURE LLC3 Filed as: ACRISURE GREAT LAKES PTR INS SVCS | 223 W GRAND AVE 1 HOWELL, MI 48843 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $162 | — | $162 | 0.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTERNATIONAL BENEFITS ADMINISTRATI EIN 11-3293162 NONE | Contract Administrator Service code 13 | 100 GARDEN CITY PLAZA SUITE 110 GARDEN CITY, NY 11530 | $734K |
| EMPIRE HEALTHCHOICE ASSURANCE INC EIN 23-7391136 NONE | Contract Administrator Service code 13 | 9 PINE STREET 14TH FLOOR NEW YORK, NY 10005 | $490K |
| FIRST FINANCIAL SERVICES 11-3043712 | Named fiduciary; Investment advisory (plan); Consulting (general); Other commissions; Custodial (securities); Distribution (12b-1) fees; Securities brokerage Service code 16 | — | $423K |
| JEANNINE DEVLIN EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $177K |
| NORTHWELL DIRECT EIN 11-3418133 NONE | Contract Administrator Service code 13 | — | $112K |
| DAWN LANGE EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $112K |
| WILMA SPATAFORE-ALVAREZ EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $67K |
| GOULD, KOBRICK, & SCHLAPP, P.C. EIN 13-3082707 UNION AUDITOR | Accounting (including auditing) Service code 10 | 192 LEXINGTON AVENUE SUITE 700 NEW YORK, NY 10016 | $54K |
| CONNECTYOURCARE LLC NONE | Contract Administrator Service code 13 | 307 INTERNATIONAL CIRCLE SUITE 200 HUNT VALLEY, MA 21030 | $49K |
| OPTUMRX EIN 33-0441200 NONE | Claims processing; Float revenue; Other fees; Direct payment from the plan; Contract Administrator Service code 12 | — | $34K |
| FACT FIRST ACTUARIAL CONSULTING EIN 26-3842522 NONE | Actuarial Service code 11 | 1501 BROADWAY SUITE 1728 NEW YORK, NY 10036 | $20K |
| HOLM & OHARA EIN 13-3591118 UNION ATTORNEY | Legal Service code 29 | 3 WEST 35TH STREET 9TH FLOOR NEW YORK, NY 10001 | $17K |
| DORIS KOENIG EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $15K |
| SYNTONIC SYSTEMS INC. EIN 13-2925049 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $8K |
| KOBGO ASSOCIATES EIN 13-2751089 NONE | Accounting (including auditing) Service code 10 | — | $7K |
| ACRISURE DBA UNION BEN PLANNERS EIN 26-3554645 NONE | Contract Administrator Service code 13 | — | $0 |
| FIRST FINANCIAL SERVICES EIN 11-3043712 NONE | Named fiduciary; Securities brokerage; Distribution (12b-1) fees; Custodial (securities); Other commissions; Consulting (general); Investment advisory (plan) Service code 16 | 38 KINGS HIGHWAY HAUPPAUGE, NY 11788 | $0 |
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 | 786 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 796 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTCARE DELIVERY SYSTEMS | 800 | $735K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 810 | $163K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 810 | $44K |
| Stop-loss / reinsurancereinsurance | UNITED STATES FIRE INSURANCE COMPANY | 800 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 810 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.