| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAWRENCE SPEILLER3 Filed as: LAWRENCE A. SPEILLER | P O BOX 311 PLAINVIEW, NY 11803 | THE UNITED STATES LIFE INSURANCE COMPANY | $878 | — | $878 | 2.76% |
| ALAN C. COHEN3 | 44 BROADWAY GREENLAWN, NY 11740 | THE UNITED STATES LIFE INSURANCE COMPANY | $878 | — | $878 | 2.76% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MONICA GIAMPOLO EIN 13-5679400 PERF. SERV. FOR REL PLANS | Employee (plan) Service code 30 | — | $88K |
| CONNIE HENRY EIN 13-5679400 PERF. SERV. FOR REL PLANS | Employee (plan) Service code 30 | — | $76K |
| GORLICK, KRAVITZ, LISTHAUS PC EIN 13-3790829 PERF. SERV. FOR REL PLANS | Legal Service code 29 | — | $62K |
| SEGAL COMPANY EIN 13-1835864 PERF. SERV. FOR REL PLANS | Actuarial Service code 11 | — | $55K |
| LERNER LAW FIRM EIN 27-3629002 PERF. SERV. FOR REL PLANS | Legal Service code 29 | — | $26K |
| BUCHBINDER TUNICK & CO. LLP EIN 13-1578842 PERF. SERV. FOR REL PLANS | Accounting (including auditing) Service code 10 | — | $25K |
| SYNTONIC SYSTEMS, INC. EIN 13-2925049 PERF. SERV. FOR REL PLANS | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $9K |
| MERRILL LYNCH EIN 13-5674085 PERF. SERV. FOR REL PLANS | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Investment advisory (plan); Custodial (securities) Service code 19 | — | $9K |
| MSI TECHNOLOGIES, LLC EIN 22-3827881 PERF. SERV. FOR REL PLANS | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $6K |
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 | 165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OXFORD HEALTH INSURANCE, INC. | 448 | $3.4M |
| Life insurance | THE UNITED STATES LIFE INSURANCE COMPANY | 167 | $32K |
| Other | THE UNITED STATES LIFE INSURANCE COMPANY | 167 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 448 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.