| 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 | $460K | — | $460K | 28.83% |
| ANTHEM INSURANCE COMPANIES, INC.3 Filed as: ANTHEM BCBS | PO BOX 1973 MORRISTOWN, NJ 07962 | US FIRE INSURANCE COMPANY | $81K | — | $81K | 5.09% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $47K | — | $47K | 15.53% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DR CENTER II STE 305 ELMWOOD PARK, NJ 07407 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $35K | $35K | 17.95% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 65 MADISON AVE SUITE 200 CHESTER, NJ 07930 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $6K | — | $6K | 3.09% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $27K | — | $27K | 15.58% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $19K | — | $19K | 15.39% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DR CENTER II STE 305 ELMWOOD PARK, NJ 07407 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $8K | $8K | 14.94% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 65 MADISON AVE SUITE 200 CHESTER, NJ 07930 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $3K | — | $3K | 6.53% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $972 | — | $972 | 15.33% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $605 | — | $605 | 13.42% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 770 KENMOOR AVE SUITE 300 GRAND RAPIDS, MI 49546 | DENTCARE DELIVERY SYSTEMS | $394 | — | $394 | 16.11% |
| 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 | $726K |
| EMPIRE HEALTHCHOICE ASSURANCE INC EIN 23-7391136 NONE | Contract Administrator Service code 13 | 9 PINE STREET 14TH FLOOR NEW YORK, NY 10005 | $527K |
| FIRST FINANCIAL SERVICES 11-3043712 | Custodial (securities); Distribution (12b-1) fees; Investment advisory (plan); Securities brokerage; Consulting (general); Named fiduciary; Other commissions Service code 16 | — | $412K |
| JEANNINE DEVLIN EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $171K |
| DAWN LANGE EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $102K |
| WILMA SPATAFORE-ALVAREZ EIN 11-6043757 NONE | Employee (plan) Service code 30 | — | $74K |
| CONNECTYOURCARE LLC NONE | Contract Administrator Service code 13 | 307 INTERNATIONAL CIRCLE SUITE 200 HUNT VALLEY, MA 21030 | $49K |
| 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 | $49K |
| OPTUMRX EIN 33-0441200 NONE | Contract Administrator; Direct payment from the plan; Other fees; Float revenue; Claims processing Service code 12 | — | $36K |
| FACT FIRST ACTUARIAL CONSULTING EIN 26-3842522 NONE | Actuarial Service code 11 | 1501 BROADWAY SUITE 1728 NEW YORK, NY 10036 | $24K |
| HOLM & OHARA EIN 13-3591118 UNION ATTORNEY | Legal Service code 29 | 3 WEST 35TH STREET 9TH FLOOR NEW YORK, NY 10001 | $21K |
| SYNTONIC SYSTEMS INC. EIN 13-2925049 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $8K |
| ACRISURE DBA UNION BEN PLANNERS EIN 26-3554645 NONE | Contract Administrator Service code 13 | — | $0 |
| FIRST FINANCIAL SERVICES EIN 11-3043712 NONE | Named fiduciary; Investment advisory (plan); Consulting (general); Other commissions; Custodial (securities); Distribution (12b-1) fees; Securities brokerage 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 | 810 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 819 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(6 contracts) | DENTCARE DELIVERY SYSTEMS | 396 | $615K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 811 | $194K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 811 | $52K |
| Stop-loss / reinsurancereinsurance | US FIRE INSURANCE COMPANY | 791 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 811 | — |
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.