| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAKESHORE BENEFIT GROUP INSURANCE3 Filed as: LAKESHORE BENEFIT GROUP LLC | 301 ALBANY TURNPIKE CANTON, CT 06019 | AETNA LIFE INSURANCE COMPANY | $7K | — | $7K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 38-2383171 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $191K |
| AETNA EIN 23-2229683 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $96K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $30K |
| COHEN, WEISS AND SIMON LLP EIN 13-1592323 NONE | Legal; Direct payment from the plan Service code 29 | — | $19K |
| JOHN OMEARA EIN 47-1997387 NONE | Trustee (individual); Direct payment from the plan Service code 20 | — | $13K |
| ELIXIR SOLUTIONS EIN 90-1011712 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $11K |
| ADMINISTRATIVE SERVICES ONLY EIN 11-2995970 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $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 | 287 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 287 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 293 | $218K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.