| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, | $19K | — | $19K | 2.70% |
| BLASCH JOHN3 | 71 BEECHWOOD LANE BERKELEY HEIGHTS, NJ 07922 | THE HARTFORD LIFE INSURANCE COMPANY | $5K | $1K | $7K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE CO EIN 23-7391136 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $573K |
| LOCAL 8A-28A WELFARE EIN 13-5624028 NONE | Direct payment from the plan; Other services Service code 49 | — | $122K |
| KMR SYSTEMS CORP EIN 13-3192128 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $115K |
| BARNES, IACCARINO, & SHEPPARD EIN 26-3858697 NONE | Legal; Direct payment from the plan Service code 29 | — | $96K |
| MELISSA VELAZQUEZ EIN 13-3562352 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $94K |
| ZAIDA DE LA CRUZ EIN 13-3562352 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| MARSHALL & MOSS,LLP EIN 11-3360166 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $76K |
| MARSHALL & MOSS,PAYROLL COMPLIANCE EIN 04-3652965 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $68K |
| INNOVATIVE SOFTWARE SOLUTIONS INC EIN 23-2182079 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $60K |
| PITTA LLP EIN 26-3852082 NONE | Legal; Direct payment from the plan Service code 29 | — | $50K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $46K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $32K |
| SECOVA INC. EIN 22-3544772 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $23K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $22K |
| AMALGAMATED BANK OF NY EIN 13-4920330 NONE | Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $20K |
| LOCKTIGHT SOLUTIONS NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 2166 BROADWAY SUITE 17D NEW YORK, NY 10024 | $17K |
| METROPOLITAN MANAGEMENT SRVCS, INC. EIN 45-3845437 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $10K |
| AMERICAN REALTY ADVISORS EIN 33-0123114 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $7K |
| SEGAL ROGERSCASEY EIN 13-2646110 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $5K |
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 | 1,052 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 30 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,082 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE UNION LABOR LIFE INSURANCE COMPANY | 755 | $706K |
| Life insurance | THE HARTFORD LIFE INSURANCE COMPANY | 676 | $26K |
| Stop-loss / reinsurancereinsurance | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, | 1,082 | $715K |
| Other | THE HARTFORD LIFE INSURANCE COMPANY | 676 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,082 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.