| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONTEMPORARY STRATEGIC SOLUTIONS4 | 19 WILLOW LANE SPRING LAKE HEIGHTS, NJ 07762 | THE UNION LABOR LIFE INSURANCE COMPANY | $30K | — | $30K | 8.00% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INS SERVICES INC | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | ANTHEM LIFE AND DISABILITY INS CO | $1K | $128 | $2K | 5.41% |
| BODNER BENEFITS GROUP INC3 | 4 CYR CT NEW CITY, NY 10956 | ANTHEM LIFE AND DISABILITY INS CO | $2K | — | $2K | 5.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| R. BASULTO EIN 13-5520944 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $154K |
| ANTHEM HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Float revenue; Other services; Claims processing; Direct payment from the plan; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $138K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $122K |
| P. KIERNAN EIN 13-5520944 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $101K |
| S. D FREDA EIN 13-5520944 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $99K |
| BENESYS, INC. EIN 38-2383171 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $48K |
| THE SEGAL CO (EASTERN STATES), INC. EIN 13-1835864 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $43K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Direct payment from the plan; Claims processing; Contract Administrator; Other fees Service code 12 | — | $39K |
| CYBERSECOP EIN 82-5102442 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $37K |
| LABOR FIRST, LLC EIN 06-1750191 NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $21K |
| COLLERAN, O'HARA & MILLS LLP EIN 11-2940050 LEGAL | Legal; Direct payment from the plan Service code 29 | — | $21K |
| INTERNATIONAL FOUNDATION OF EMPLOYE NONE | Other services; Direct payment from the plan Service code 49 | 18700 W. BLUEMOUND RD BROOKFIELD, WI 53045 | $15K |
| GUARDIAN LIFE INSURANCE EIN 13-5123390 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $14K |
| GREGORY MATTHEW WEALTH MANAGEMENT EIN 11-3600438 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $13K |
| PAYCHEX EIN 16-1124166 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $6K |
| SEGAL SELECT INSURANCE SVCS, INC. EIN 46-0619194 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $1K |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 101 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 291 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | ANTHEM LIFE AND DISABILITY INS CO | 283 | $30K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 220 | $375K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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."
No prospect flags tripped on this filing.