| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC. | 1000 WOODBURY ROAD, SUITE 403 WOODBURY, NY 11797 | HARTFORD LIFE AND ACCIDENT | $38K | $13K | $51K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MIDWEST LIMITED | 55 E. JACKSON STE 14B CHICAGO, IL 60604 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 1.04% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC. | 1000 WOODBURY ROAD, SUITE 403 WOODBURY, NY 11797 | HARTFORD LIFE AND ACCIDENT | $20K | $0 | $20K | 19.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MIDWEST LIMITED | 55 E. JACKSON STE 14B CHICAGO, IL 60604 | HARTFORD LIFE AND ACCIDENT | $0 | $1K | $1K | 1.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PABON FINANCIAL SERVICES, LLC EIN 84-3599895 NONE | Accounting (including auditing) Service code 10 | — | $67K |
| MORGAN STANLEY SMITH BARNEY, LLC EIN 20-8764829 NONE | Other investment fees and expenses; Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $43K |
| BUCHBINDER TUNICK & CO LLP EIN 13-1578842 NONE | Accounting (including auditing) Service code 10 | — | $26K |
| JEFFREY S. DUBIN,ESQ. EIN 11-2542303 NONE | Legal Service code 29 | — | $23K |
| PROSKAUER ROSE, LLP EIN 13-1840454 ATT'Y FOR EMPLOYER ASSN. | Legal Service code 29 | — | $17K |
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 | 480 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 480 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 316 | $254K |
| Other(2 contracts) | HARTFORD LIFE AND ACCIDENT | 480 | $353K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 480 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.