| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FNA INSURANCE SERVICES INC3 | — | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $4K | $3K | $7K | 11.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE BLUE CROSS BLUE SHIELD EIN 23-7391136 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing; Other services Service code 12 | — | $203K |
| L. FUSCO EIN 13-5520944 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $144K |
| P. KIERNAN EIN 13-5520944 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $82K |
| R. BASULTO EIN 13-5520944 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $80K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $77K |
| S. D. FREDA EIN 13-5520944 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| FIRST ACTUARIAL CONSULTING, INC EIN 26-3842522 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $49K |
| COLLERAN, O'HARA & MILLS LLP EIN 11-2940050 LEGAL | Legal; Direct payment from the plan Service code 29 | — | $26K |
| CLEARARC CAPITAL, INC EIN 31-1051736 NONE | Investment management fees paid indirectly by plan; Investment management; Investment management fees paid directly by plan; Soft dollars commissions Service code 28 | — | $19K |
| GUARDIAN LIFE INSURANCE COMPANY EIN 13-5123390 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $19K |
| DTM CONSULTING EIN 04-3607413 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $18K |
| DECUSOFT, LLC EIN 02-0643827 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $12K |
| C&R CONSULTING, INC. EIN 13-3935364 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $9K |
| AMALGAMATED BANK OF NY EIN 13-4920330 NONE | Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $5K |
| FIFTH THIRD BANK RETIREMENT SERVICE EIN 31-1051736 NONE | Float revenue; Soft dollars commissions; Direct payment from the plan; Custodial (securities) Service code 19 | — | $2K |
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 | 318 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 97 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 415 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 404 | $60K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC. (G1921) | 825 | $404K |
| Other | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 404 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 825 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.