| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SURACY INSURANCE AGENCY INC3 | 6001 COCHRAN ROAD SUITE 402 SOLON, OH 44139 | WESCO INSURANCE COMPANY | $41K | — | $41K | 4.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE INC EIN 23-7391136 NONE | Other services; Claims processing; Direct payment from the plan; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $6.8M |
| SCHULTHEIS & PANETTIERI LLP EIN 13-1577780 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $1.7M |
| VIRGINIA & AMBINDER LLP EIN 13-4166736 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $1.6M |
| EXPRESS SCRIPTS INC EIN 22-3461740 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $1.3M |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $1.2M |
| ADMINISTRATIVE SERVICES ONLY INC EIN 11-2995970 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $567K |
| INNOVATIVE SOFTWARE SOLUTIONS INC. EIN 23-2182079 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $439K |
| STEWART DAVID EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $373K |
| LOOMIS SAYLES TRUST COMPANY EIN 20-8080381 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $308K |
| KAUFF MCGUIRE & MARGOLIS LLP EIN 13-3573855 NONE | Legal; Direct payment from the plan Service code 29 | — | $308K |
| LESNIEWSKI ROBERT EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $306K |
| WESTERN ASSET MANAGEMENT COMPANY EIN 52-1200960 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $262K |
| LAZARD ASSET MANAGEMENT LLC EIN 05-0530199 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $233K |
| MUNICIPAL ASSET MANAGEMENT EIN 13-3751894 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $210K |
| LORD ABBETT & CO LLC EIN 13-5620131 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $198K |
| HARVARD PROTECTION SERVICES EIN 13-4127048 SECURITY PROVIDER | Direct payment from the plan; Other services Service code 49 | — | $192K |
| JACOBSEN DAVID EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $189K |
| THE SEGAL COMPANY (EASTERN STATES) EIN 13-1835864 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $178K |
| LAMBERT BENJAMIN EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $172K |
| ROGER E. MAHER ARBITRATOR | Legal; Direct payment from the plan Service code 29 | 23 83RD STREET BROOKLYN, NY 11209 | $158K |
| CONSIDINE FRANCES EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $149K |
| O'BRIEN FOWLKES KRISTIN EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $149K |
| BAHN PLLC EIN 84-3431469 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $148K |
| FIACCO GINO EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $145K |
| BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Direct payment from the plan; Float revenue; Custodial (securities); Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Shareholder servicing fees Service code 19 | — | $144K |
| PAYDEN & RYGEL EIN 95-3921788 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $132K |
| DAVIDIAN WILLIAM EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $125K |
| SCHMIDT MONICA EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $125K |
| GROSSMAN MARLENE EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $124K |
| HERNSDORF BRYCE EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $122K |
| ALISHAYEVA OLGA EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $121K |
| PADULA JILLIAN EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $116K |
| MINETELLO GERARD F EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $106K |
| CASEY JENNIFER EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $99K |
| MOY TAMMY EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $99K |
| SEGAL SELECT INSURANCE SERVICES EIN 46-0619194 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $97K |
| MARTINEZ STEVEN R. EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| SCHILLING EILEEN EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $95K |
| LACEY GINA EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $95K |
| GRAHAM VIRGINIA EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $93K |
| OZARD CHRISTOPHER EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| VELAJ SENADA EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| SOLAAS STEVEN EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| MITCHELL SONYA EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| CLARKE MAUREEN EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| HANLEY JOAN EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| SANCHEZ CIONGOLI KATHERINE EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| WOLSKY JONATHAN EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| HERNANDEZ JESSICA EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| ORTIZ (RAMOS) MONIQUE EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $75K |
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 | 14,658 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6,464 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 21,122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 45,136 | $2.3M |
| Other(3 contracts, 3 carriers) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 45,136 | $11.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 45,136 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.