| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION SY | 99 PARK AVE. - 25TH FLOOR NEW YORK, NY 10016 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $816 | — | $816 | 1.54% |
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION SY | 99 PARK AVE. - 25TH FLOOR NEW YORK, NY 10016 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| C & R CONSULTING EIN 13-3935364 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $449K |
| EMPIRE HEALTHCHOICE ASSURANCE INC EIN 23-7391136 NONE | Float revenue; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Direct payment from the plan Service code 12 | — | $228K |
| MILLIMAN INC EIN 91-0675641 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $106K |
| PROSKAUER ROSE LLP EIN 13-1840454 NONE | Legal; Direct payment from the plan Service code 29 | — | $85K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $39K |
| ALICARE MEDICAL MANAGEMENT EIN 13-3860528 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $38K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $37K |
| MEYER, SUOZZI, ENGLISH & KLEIN, PC EIN 11-2340639 NONE | Legal; Direct payment from the plan Service code 29 | — | $31K |
| H.J. KNIGHT INTERNATIONAL EIN 04-2960092 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $21K |
| DIANA ROSS NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 160 WEST END AVENUE, APT 24E NEW YORK, NY 10023 | $18K |
| QUAN-VEST CONSULTANTS INC. EIN 11-2559669 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $11K |
| HORIZON ACTUARIAL SERVICES LLC EIN 26-1370698 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $8K |
| PENN CAPITAL MANAGEMENT CO., INC. EIN 22-2796848 NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $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 | 875 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 485 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,360 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | OXFORD HEALTH INSURANCE INC | 7 | $236K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $53K |
| Life insurance(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 874 | $18K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 855 | $286K |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 874 | — |
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.