| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MSM GENERAL AGENCY INC3 | PO BOX 060470 STATEN ISLAND, NY 10306 | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | — | $18K | $18K | 4.62% |
| MICHAEL FERRONE3 | 34 SHIRA LANE MANALAPAN, NJ 07726 | JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A) | $29K | — | $29K | 9.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NY HTC&HA OF NYC HEALTH CENTER, INC EIN 13-1595091 AFFILIATE OF PLAN | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $84K |
| ADP, INC. EIN 22-1467904 PAYROLL PROCESSING | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $10K |
| ARMAO LLP EIN 46-2754053 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $9K |
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 | 1,003 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,003 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | HARTFORD LIFE INSURANCE CO. | 977 | $550K |
| Long-term disability | HARTFORD LIFE INSURANCE CO. | 554 | $160K |
| Other(2 contracts, 2 carriers) | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | 1,007 | $705K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,007 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.