| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANNA REIS3 | 263 CEDARCROFT AVE AUDOBON, NJ 08106 | AFLAC | — | $37 | $37 | 4.71% |
| ANNA REIS3 | 5712B ADELAIDE DR MOUNT LAUREL, NJ 08054 | AFLAC | — | $12 | $12 | 1.53% |
| COLLEEN ODONOVAN3 | 47 BANBURY ROAD LUMBERTON, NJ 08048 | AFLAC | — | $10 | $10 | 1.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE BLUE CROSS BLUE SHIELD EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing; Float revenue Service code 12 | 3350 PEACHTREE ROAD POB 30302-445 ATLANTA, GA 303261039 | $324K |
| ELEFTHERIOS TERRY VOUVOUDAKIS EIN 13-6118206 NONE | Employee (plan) Service code 30 | — | $110K |
| ROBIN YOUNG-TYRELL EIN 13-6118206 NONE | Employee (plan) Service code 30 | — | $109K |
| MICHAEL SAROSY EIN 13-6118206 NONE | Employee (plan) Service code 30 | — | $100K |
| DANIEL H. COOK ASSOCIATES, INC. EIN 11-2424843 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Plan Administrator Service code 12 | 253 W 35TH STREET 12TH FL NEW YORK, NY 10001 | $82K |
| BROADREACH MEDICAL RESOURCES EIN 02-0640082 NONE | Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $60K |
| LABOR FIRST LLC EIN 06-1750191 NONE | Insurance agents and brokers Service code 22 | 300 CHESTER AVE STE 300 MOORESTOWN, NJ 08057 | $40K |
| GOULD KOBRICK & SCHLAPP PC EIN 13-3082707 NONE | Accounting (including auditing) Service code 10 | 3 PARK AVE 14TH FL NEW YORK, NY 10016 | $31K |
| VIRGINIA & AMBINDER, LLP EIN 13-4166736 ATTORNEY | Legal Service code 29 | — | $28K |
| COLLERAN OHARA & MILLS L.L.P. EIN 11-2940050 UNION ATTORNEY | Other services; Other fees; Legal Service code 29 | 1225 FRANKLIN AVE SUITE 450 GARDEN CITY, NY 11530 | $24K |
| WELBY, BRADY & GREENBLATT, LLP EIN 13-3864481 ATTORNEY | Legal Service code 29 | 11 MARTINE AVE 15TH FLOOR WHITE PLAINS, NY 10606 | $22K |
| THE SEGAL COMPANY EIN 13-2518466 NONE | Actuarial Service code 11 | — | $18K |
| WORKFORCE ASSIST. PROG & CONSULTING EIN 20-8231145 NONE | Consulting (general) Service code 16 | 211 E MAIN ST 161 NEW ROCHELLE, NY 10801 | $14K |
| JPMORGAN CHASE BANK, N.A. EIN 13-4994650 | Custodial (other than securities); Account maintenance fees Service code 18 | — | $8K |
| QUAN-VEST CONSULTANTS INC. EIN 11-2559669 NONE | Investment advisory (plan) Service code 27 | 390 PLANDOME ROAD MANHASSET, NY 10122 | $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 | 480 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 138 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 618 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED AMERICAN INSURANCE | 157 | $396K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 474 | $95K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 474 | $96K |
| Prescription drug | UNITED AMERICAN INSURANCE | 157 | $395K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 474 | $375K |
| Other | UNITED AMERICAN INSURANCE | 157 | $395K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 474 | — |
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.