| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| H.J. KNIGHT INTERNATIONAL INSURANCE3 Filed as: H.J. KNIGHT INTERNATIONAL | 30 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | HCC LIFE INSURANCE COMPANY | — | $16K | $16K | 4.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| C & R CONSULTING, INC. EIN 13-3935364 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $233K |
| EMPIRE HEALTHCHOICE ASSURANCE INC EIN 23-7391136 NONE | Float revenue; Other services; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $171K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $63K |
| PROSKAUER ROSE LLP EIN 13-1840454 NONE | Legal; Direct payment from the plan Service code 29 | — | $53K |
| FIRST ACTUARIAL CONSULTING INC EIN 26-3842522 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $40K |
| O'DWYER & BERNSTEIN, LLP EIN 13-5286665 NONE | Legal; Direct payment from the plan Service code 29 | — | $19K |
| ALICARE MEDICAL MANAGEMENT INC EIN 13-3860528 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $17K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Direct payment from the plan; Other fees; Claims processing; Float revenue Service code 12 | — | $16K |
| DIANA G ROSS NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 160 WEST END AVE., APT 24E NEW YORK, NY 10023 | $10K |
| PRUDENTIAL RETIREMENT INSURANCE AND EIN 06-1050034 NONE | Other services; Direct payment from the plan Service code 49 | — | $9K |
| QUAN-VEST CONSULTANTS, INC. EIN 11-2559669 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $7K |
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 | 239 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 388 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 627 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 236 | $346K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.