| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FNA INSURANCE SERVICES INC3 | — | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $3K | $3K | $6K | 11.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE INC EIN 23-7391136 NONE | Float revenue; Direct payment from the plan; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing Service code 12 | — | $223K |
| L. FUSCO EIN 13-5520944 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $136K |
| R. BASULTO EIN 13-5520944 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $88K |
| P. KIERNAN EIN 13-5520944 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $85K |
| S. D. FREDA EIN 13-5520944 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $56K |
| COLLERAN, O'HARA & MILLS LLP EIN 11-2940050 LEGAL | Legal; Direct payment from the plan Service code 29 | — | $43K |
| FIRST ACTUARIAL CONSULTING, INC EIN 26-3842522 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $29K |
| CLEARARC CAPITAL, INC EIN 31-1051736 NONE | Investment management; Direct payment from the plan Service code 28 | — | $21K |
| NGUARD, INC. EIN 94-3429660 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $21K |
| GUARDIAN LIFE INSURANCE COMPANY EIN 13-5123390 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $19K |
| 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 | Claims processing; Direct payment from the plan Service code 12 | — | $8K |
| EXPRESS SCRIPTS INC EIN 43-1420563 NONE | Contract Administrator; Direct payment from the plan; Other fees; Claims processing Service code 12 | — | $6K |
| FIFTH THIRD BANK RETIREMENT SERVICE EIN 31-1051736 NONE | Soft dollars commissions; Custodial (securities); Float revenue; Direct payment from the plan 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 | 304 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 99 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 403 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 393 | $55K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC. (G1921) | 771 | $383K |
| Other | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 393 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 771 | — |
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.