| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 85 CHESTNUT RIDGE RD, STE 214 MONTVALE, NJ 07645 | HCC LIFE INSURANCE COMPANY | $39K | $7K | $46K | 11.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 85 CHESTNUT RIDGE RD, STE 214 MONTVALE, NJ 07645 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, | $35K | $6K | $42K | 11.80% |
| JOHN H BLASCH3 | 71 BEECHWOOD LANE BERKLEY HEIGHTS, NJ 07922 | THE HARTFORD LIFE INSURANCE COMPANY | $6K | $1K | $7K | 25.00% |
| JOHN H BLASCH3 | 71 BEECHWOOD LANE BERKLEY HEIGHTS, NJ 07922 | SYMETRA LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE CO EIN 23-7391136 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $575K |
| BARNES, IACCARINO, & SHEPERD LLP EIN 26-3858697 NONE | Legal; Direct payment from the plan Service code 29 | — | $288K |
| JOSEPH RAMAGLIA EIN 13-3562352 EMPLOYEE | Recordkeeping fees; Employee (plan) Service code 30 | — | $119K |
| MARSHALL & MOSS,LLP EIN 11-3360166 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $98K |
| MELISSA VELAZQUEZ EIN 13-3562352 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| KMR SYSTEMS CORP EIN 13-3192128 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $86K |
| ZAIDA DE LA CRUZ EIN 13-3562352 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| PITTA LLP EIN 26-3852082 NONE | Legal; Direct payment from the plan Service code 29 | — | $60K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $48K |
| MARSHALL & MOSS,PAYROLL COMPLIANCE EIN 04-3652965 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $45K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $34K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $32K |
| WORKFORCE ASSISTANCE PROGRAMS NONE | Direct payment from the plan; Other services Service code 49 | 211 EAST MAIN ST, 161 NEW ROCHELLE, NY 10801 | $31K |
| GALLAGHER BENEFIT SERVICES INC EIN 36-2481781 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $30K |
| ADMINISTRATIVE SERVICES ONLY EIN 11-2995970 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $23K |
| CONTEGIX LLC EIN 23-2826293 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $20K |
| AMALGAMATED BANK OF NY EIN 13-4920330 NONE | Other services; Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $19K |
| AMERICAN REALTY ADVISORS EIN 33-0123114 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $13K |
| 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 | $12K |
| CORNERSTONE MEDICAL ARTS EIN 13-1030650 NONE | Other services; Direct payment from the plan Service code 49 | — | $12K |
| 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 | 1,112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | THE HARTFORD LIFE INSURANCE COMPANY | 742 | $42K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 794 | $739K |
| Other(2 contracts, 2 carriers) | THE HARTFORD LIFE INSURANCE COMPANY | 742 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,199 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.