| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | US FIRE INSURANCE COMPANY | $464K | — | $464K | 35.01% |
| ANTHEM INSURANCE COMPANIES, INC.3 Filed as: ANTHEM BCBS | PO BOX 1973 MORRISTOWN, NJ 07962 | US FIRE INSURANCE COMPANY | $81K | — | $81K | 6.09% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $44K | — | $44K | 10.34% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $26K | — | $26K | 10.27% |
| EMERSON REID LLC3 | 1787 SENTRY PWY W VEVA 16 320 BLUE BELL, PA 19422 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $33K | $33K | 18.67% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 120 EAGLE ROCK AVENUE STE 195 EAST HANOVER, NJ 07936 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $4K | — | $4K | 2.45% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $18K | — | $18K | 10.54% |
| EMERSON REID LLC3 | 1787 SENTRY PWY W VEVA 16 320 BLUE BELL, PA 19422 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $8K | $8K | 15.67% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 120 EAGLE ROCK AVENUE STE 195 EAST HANOVER, NJ 07936 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $3K | — | $3K | 5.96% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $1K | — | $1K | 11.31% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $651 | — | $651 | 13.11% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $330 | — | $330 | 10.28% |
| 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 | $731K |
| EMPIRE HEALTHCHOICE ASSURANCE INC EIN 23-7391136 NONE | Contract Administrator Service code 13 | 9 PINE STREET 14TH FLOOR NEW YORK, NY 10005 | $419K |
| FIRST FINANCIAL SERVICES 11-3043712 | Named fiduciary; Securities brokerage; Investment advisory (plan); Consulting (general); Other commissions; Distribution (12b-1) fees; Custodial (securities) Service code 16 | — | $364K |
| JEANNINE DEVLIN EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $166K |
| OPTUMRX EIN 33-0441200 NONE | Other fees; Direct payment from the plan; Contract Administrator; Claims processing; Float revenue Service code 12 | — | $100K |
| DAWN LANGE EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $91K |
| WILMA SPATAFORE-ALVAREZ EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $68K |
| CONNECTYOURCARE LLC NONE | Contract Administrator Service code 13 | 307 INTERNATIONAL CIRCLE SUITE 200 HUNT VALLEY, MA 21030 | $47K |
| 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 | $42K |
| CRAFT SKILL REALTY CORPORATION EIN 47-2071062 OWN & OPERATE LAND & BLDG | Other services Service code 49 | — | $30K |
| 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 | $12K |
| 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 |
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 | 776 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 789 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(6 contracts) | DENTCARE DELIVERY SYSTEMS | 391 | $863K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 804 | $179K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 804 | $48K |
| Stop-loss / reinsurancereinsurance | US FIRE INSURANCE COMPANY | 820 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 820 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.