| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HJ KNIGHT INTERNATIONAL3 Filed as: HJ KNIGHT INTERNATIONAL INS AGENCY | 30 BRAINTREE HILL OFFICE PARK SUITE 203 BRAINTREE, MA 02184 | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | $9K | — | $9K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| C & R CONSULTING, INC. EIN 13-3935364 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $423K |
| EMPIRE HEALTH CHOICE ASSURANCE EIN 23-7391136 NONE | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Claims processing Service code 12 | — | $227K |
| PROSKAUER ROSE LLP EIN 13-1840454 NONE | Legal; Direct payment from the plan Service code 29 | — | $192K |
| MEYER, SUOZZI, ENGLISH & KLEIN EIN 11-2340639 NONE | Legal; Direct payment from the plan Service code 29 | — | $57K |
| FIRST ACTUARIAL CONSULTING, INC. EIN 26-3842522 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $57K |
| MARTIN SCHEINMAN, ESQ EIN 11-2592796 NONE | Direct payment from the plan; Other fees Service code 50 | — | $40K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $36K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $35K |
| KAUFF KAUFF, MCGUIRE & MARGOLIS LLP EIN 13-3573855 NONE | Legal; Direct payment from the plan Service code 29 | — | $32K |
| STEINBERG, STECKLER & PICCIURRO, PC EIN 13-2665700 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $22K |
| ALICARE EIN 13-3432221 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $18K |
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 | 497 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 282 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 779 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 620 | $13K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 492 | $214K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 620 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.