| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | GARDEN STATE LIFE INSURANCE COMPANY | $456K | — | $456K | 39.25% |
| ANTHEM INSURANCE COMPANIES, INC.3 Filed as: ANTHEM BCBS | 65 BERGEN AVENUE RIDGEFIELD PARK, NJ 07660 | GARDEN STATE LIFE INSURANCE COMPANY | $94K | — | $94K | 8.11% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | DENTCARE DELIVERY SYSTEMS | $43K | — | $43K | 12.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | DENTCARE DELIVERY SYSTEMS | $26K | — | $26K | 11.96% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | DENTCARE DELIVERY SYSTEMS | $25K | — | $25K | 12.09% |
| UNION BENEFITS PLANNER, INC.3 | 120 EAGLE ROCK AVENUE SUITE 195 EAST HANOVER, NJ 07936 | AMALGAMATED LIFE INSURANCE COMPANY | $12K | — | $12K | 16.27% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | DENTCARE DELIVERY SYSTEMS | $2K | — | $2K | 12.76% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONI, MI 49316 | DENTCARE DELIVERY SYSTEMS | $358 | — | $358 | 11.43% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | DENTCARE DELIVERY SYSTEMS | $321 | — | $321 | 11.35% |
| 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 | $702K |
| EMPIRE HEALTHCHOICE ASSURANCE INC EIN 23-7391136 NONE | Contract Administrator Service code 13 | 9 PINE STREET 14TH FLOOR NEW YORK, NY 10005 | $466K |
| FIRST FINANCIAL SERVICES 11-3043712 | Other commissions; Distribution (12b-1) fees; Consulting (general); Custodial (securities); Securities brokerage; Named fiduciary; Investment advisory (plan) Service code 16 | — | $292K |
| JEANNINE DEVLIN EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $154K |
| DAWN LANGE EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $86K |
| OPTUMRX EIN 33-0441200 NONE | Float revenue; Claims processing; Other fees; Direct payment from the plan Service code 12 | — | $85K |
| WILMA SPATAFORE-ALVAREZ EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $59K |
| CRAFT SKILL REALTY CORPORATION EIN 47-2071062 OWN & OPERATE LAND & BLDG | Other services Service code 49 | — | $29K |
| 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 | $25K |
| C&R CONSULTING SERVICES EIN 13-3935364 NONE | Claims processing; Contract Administrator Service code 12 | 1501 BROADWAY SUITE 1724 NEW YORK, NY 10036 | $16K |
| HOLM & OHARA EIN 13-3591118 UNION ATTORNEY | Legal Service code 29 | 3 WEST 35TH STREET 9TH FLOOR NEW YORK, NY 10001 | $14K |
| FACT FIRST ACTUARIAL CONSULTING EIN 26-3842522 NONE | Actuarial Service code 11 | 1501 BROADWAY SUITE 1728 NEW YORK, NY 10036 | $9K |
| KOBGO ASSOCIATES EIN 13-2751089 NONE | Accounting (including auditing) Service code 10 | — | $8K |
| SYNTONIC SYSTEMS INC. EIN 13-2925049 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $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 | 807 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 812 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(6 contracts) | DENTCARE DELIVERY SYSTEMS | 365 | $802K |
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 807 | $94K |
| Short-term disability | AMALGAMATED LIFE INSURANCE COMPANY | 806 | $76K |
| Stop-loss / reinsurancereinsurance | GARDEN STATE LIFE INSURANCE COMPANY | 788 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 807 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.