| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LABOR FIRST LLC0 | 300 CHESTER AVE STE 300 MOORESTOWN, NJ 08057 | UNITED AMERICAN INSURANCE | $53K | — | $53K | 11.75% |
| LANCE BARTON3 | 2201 N FLORIDA AVE TAMPA, FL 33602 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.89% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $103 | $103 | 0.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE BLUE CROSS BLUE SHIELD EIN 23-7391136 NONE | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | 3350 PEACHTREE ROAD POB 30302-445 ATLANTA, GA 303261039 | $257K |
| DANIEL H. COOK ASSOCIATES, INC. EIN 11-2424843 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Claims processing; Contract Administrator Service code 12 | 253 W 35TH STREET 12TH FL NEW YORK, NY 10001 | $90K |
| BROADREACH MEDICAL RESOURCES EIN 02-0640082 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other services; Contract Administrator Service code 12 | — | $39K |
| KOBGO ASSOCIATES, INC. EIN 13-2751089 NONE | Accounting (including auditing) Service code 10 | 3 PARK AVE 14TH FL NEW YORK, NY 10016 | $37K |
| COLLERAN OHARA & MILLS L.L.P. EIN 11-2940050 UNION ATTORNEY | Other services; Legal; Other fees Service code 29 | 1225 FRANKLIN AVE SUITE 450 GARDEN CITY, NY 11530 | $35K |
| GOULD KOBRICK & SCHLAPP PC EIN 13-3082707 NONE | Accounting (including auditing) Service code 10 | 3 PARK AVE 14TH FL NEW YORK, NY 10016 | $25K |
| WELBY, BRADY & GREENBLATT, LLP EIN 13-3864481 ATTORNEY | Legal Service code 29 | 11 MARTINE AVE 15TH FLOOR WHITE PLAINS, NY 10606 | $20K |
| FEDERATION PENSION BUREAU, INC. EIN 13-1787163 NONE | Actuarial Service code 11 | 225 WEST 34TH STREET NEW YORK, NY 10122 | $17K |
| MARSHALL & MOSS PAYROLL COMPLIANCE EIN 04-3652965 NONE | Accounting (including auditing) Service code 10 | 1400 OLD COUNTRY ROAD WESTBURY, NY 11590 | $9K |
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 | 533 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 141 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITED AMERICAN INSURANCE | 151 | $447K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 377 | $61K |
| Short-term disability(2 contracts) | AFLAC | 0 | $0 |
| Prescription drug | UNITED AMERICAN INSURANCE | 151 | $447K |
| Other | EVEREST REINSURANCE COMPANY | 391 | $201K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 391 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.