| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 Filed as: GREYMATTER RISK MANAGEMENT, LLC | 6505 EAST 82ND STREET, SUITE 206 INDIANAPOLIS, IN 46250 | GARDEN STATE LIFE INSURANCE COMPANY | $95K | — | $95K | 10.00% |
| THE SEGAL COMPANY3 Filed as: SEGAL GROUP | 333 WEST 34TH ST NEW YORK, NY 100012402 | GARDEN STATE LIFE INSURANCE COMPANY | $38K | — | $38K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Direct payment from the plan; Other services Service code 12 | — | $423K |
| JEAN FAIRCHILD EIN 13-5605495 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $191K |
| COHEN, WEISS & SIMON LLP EIN 13-1592323 NONE | Legal; Direct payment from the plan Service code 29 | — | $69K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $66K |
| MILDRED DIAZ EIN 13-5605495 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $62K |
| THE SEGAL CO. (EASTERN STATES), INC EIN 13-1835864 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $61K |
| JOSE D RIVERA EIN 13-5605495 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| D. D. SERVICES INC. EIN 11-2705347 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $58K |
| CRISTINA JIMENEZ EIN 13-5605495 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| NELLY DAGER EIN 13-5605495 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $41K |
| TPA COMPUTER CORPORATION EIN 13-3329882 COMPUTER CONSULTANT | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $30K |
| EXPRESS SCRIPTS INC EIN 43-1420563 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $12K |
| DTM CONSULTING LLC EIN 04-3607413 COMPUTER CONSULTANT | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $11K |
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 | 1,148 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC | 24 | $619K |
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 1,155 | $56K |
| Stop-loss / reinsurancereinsurance | GARDEN STATE LIFE INSURANCE COMPANY | 1,165 | $946K |
| Other | AMALGAMATED LIFE INSURANCE COMPANY | 1,155 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,165 | — |
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.