| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | PO BOX 4058 NEW YORK, NY 10261 | HCC LIFE INSURANCE COMPANY | $26K | — | $26K | 2.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator Service code 13 | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | $529K |
| SLEVIN & HART P.C. EIN 52-1708613 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 1300 CONNECTICUT AVENUE NW STE 700 WASHINGTON, DC 20036 | $176K |
| ROSALBA PEREZ EIN 13-1564856 PLAN ADMINISTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $170K |
| JEAN EDY JOSEPH EIN 13-1564856 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $89K |
| RAMONA AYBAR EIN 13-1564856 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $87K |
| FLORMARIA TOULSON EIN 13-1564856 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $79K |
| JOU ZOQUIER EIN 13-1564856 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $77K |
| VEDWATIE PRASAD EIN 13-1564856 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $71K |
| LOURDES LANZOT EIN 13-1564856 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $71K |
| PIERRE J. BOUTIN EIN 13-1564856 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $69K |
| CVS PHARMACY, INC EIN 05-0340626 CLAIMS PROCESSING | Claims processing; Direct payment from the plan Service code 12 | 180 PASSAIC AVE FAIRFIELD, NJ 07004 | $60K |
| LOUVINIA GREENAWAY EIN 13-1564856 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $55K |
| NELSY RODRIGUEZ EIN 13-1564856 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $46K |
| CITRIN COOPERMAN ADVISORS LLC EIN 87-2525370 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 7900 WESTPARK DR. SUITE A220 MCLEAN, VA 22102 | $45K |
| THE SEGAL COMPANY, INC. EIN 13-1835864 ACTUARIAL | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | 66 HUDSON BLVD EAST, 20TH FLOOR NEW YORK, NY 10001 | $34K |
| BARNES, IACCARINO & SHEPHERD LLP EIN 26-3858697 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 3 SURREY LANE HEMPSTEAD, NY 11550 | $31K |
| CITRIN COOPERMAN & COMPANY, LLP EIN 22-2428965 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 100 JERICHO QUADRANGLE, SUITE 342 JERICHO, NY 11753 | $28K |
| NEPC, LLC EIN 26-1429809 INVESTMENT ADVISORY | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | 225 FRANKLIN ST, 29TH FLOOR BOSTON, MA 02110 | $23K |
| HILB GROUP EIN 47-4324398 CLAIMS PROCESSING | Contract Administrator; Direct payment from the plan Service code 13 | 30 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | $22K |
| BOSTON TRUST & INVESMENT MANAGEMENT EIN 04-2273811 INVESTMENT MANAGER | Trustee (directed); Trustee (bank, trust company, or similar financial institution); Investment management Service code 21 | ONE BEACON STREET BOSTON, MA 02108 | $22K |
| VISION SCREENING EIN 11-2358021 CLAIMS PROCESSING | Claims processing; Direct payment from the plan Service code 12 | 1919 MIDDLE COUNTRY ROAD, SUITE 304 CENTEREACH, NY 11720 | $20K |
| DARIO HEALTH CORP EIN 45-2973162 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator Service code 13 | 322 W 57 STREET, 33B NEW YORK, NY 10019 | $19K |
| AMALGAMATED BANK EIN 13-4920330 PLAN CUSTODIAN | Direct payment from the plan; Custodial (securities) Service code 19 | 275 7TH AVENUE NEW YORK, NY 10001 | $6K |
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 | 1,318 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SOLSTICE BENEFITS, INC. | 2,435 | $369K |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 1,992 | $70K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,320 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,435 | — |
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.