| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SURACY INSURANCE AGENCY INC3 | 6001 COCHRAN ROAD SUITE 402 SOLON, OH 44139 | TECHNOLOGY INSURANCE COMPANY | $33K | — | $33K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE INC. EIN 23-7391136 NONE | Direct payment from the plan; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $5.5M |
| EXPRESS SCRIPTS INC EIN 22-3461740 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $2.0M |
| SCHULTHEIS & PANETTIERI LLP EIN 13-1577780 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $1.8M |
| VIRGINIA & AMBINDER LLP EIN 13-4166736 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $1.5M |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $1.5M |
| ADMINISTRATIVE SERVICES ONLY INC EIN 11-2995970 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $551K |
| THE SEGAL COMPANY (EASTERN STATES) EIN 13-1835864 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $426K |
| KAUFF MCGUIRE & MARGOLIS LLP EIN 13-3573855 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $382K |
| INNOVATIVE SOFTWARE SOLUTIONS INC EIN 23-2182079 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $364K |
| LESNIEWSKI ROBERT EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $316K |
| LORD ABBETT & CO LLC EIN 13-5620131 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $295K |
| WESTERN ASSET MANAGEMENT COMPANY EIN 52-1200960 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $273K |
| O'BRIEN FOWLKES KRISTIN EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $261K |
| LOOMIS SAYLES TRUST COMPANY EIN 20-8080381 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $242K |
| BAHN PLLC EIN 84-3431469 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $212K |
| HARVARD PROTECTION SERVICES EIN 13-4127048 SECURITY PROVIDER | Other services; Direct payment from the plan Service code 49 | — | $203K |
| ROGER E. MAHER ARBITRATOR | Legal; Direct payment from the plan Service code 29 | 23 83RD STREET BROOKLYN, NY 11209 | $194K |
| JACOBSEN DAVID EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $191K |
| LAZARD ASSET MANAGEMENT LLC EIN 05-0530199 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $187K |
| BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Investment management fees paid indirectly by plan; Direct payment from the plan; Investment management fees paid directly by plan; Shareholder servicing fees; Custodial (securities); Float revenue Service code 19 | — | $177K |
| LAMBERT BENJAMIN EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $176K |
| CONSIDINE FRANCES EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $154K |
| FIACCO GINO EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $146K |
| DAVIDIAN WILLIAM EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $138K |
| CORDERO LUIS EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $136K |
| STEWART DAVID EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $131K |
| HERNSDORF BRYCE EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $128K |
| SCHMIDT MONICA EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| GROSSMAN MARLENE EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $125K |
| ALISHAYEVA OLGA EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $123K |
| PADULA JILLIAN EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $122K |
| CASEY JENNIFER EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $117K |
| MINETELLO GERARD F EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $112K |
| MCMAHON MATTHEW EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $107K |
| MOY TAMMY EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $105K |
| MARTINEZ STEVEN R. EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $105K |
| LACEY GINA EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $101K |
| SCHILLING EILEEN EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $99K |
| GRAHAM VIRGINIA EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $96K |
| OZARD CHRISTOPHER EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $93K |
| VELAJ SENADA EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| DAVILA ALICIA EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| PAYDEN & RYGEL EIN 95-3921788 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $88K |
| SOLAAS STEVEN EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| SEGAL SELECT INSURANCE SERVICES EIN 46-0619194 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $86K |
| OSHANANI EDMOND EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $85K |
| MITCHELL SONYA EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $85K |
| CLARKE MAUREEN EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| HANLEY JOAN EIN 13-5615576 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| HERNANDEZ JESSICA EIN 13-5615576 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
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 | 13,594 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6,584 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 20,178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 44,135 | $2.3M |
| Other(3 contracts, 3 carriers) | AMALGAMATED LIFE INSURANCE COMPANY | 44,135 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 44,135 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.