| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 120 EAGLE ROCK AVENUE, SUITE 195 EAST HANOVER, NJ 07936 | THE HARTFORD | $28K | — | $28K | 23.50% |
| ACRISURE LLC3 | 120 EAGLE ROCK AVENUE, SUITE 195 EAST HANOVER, NJ 07936 | THE HARTFORD | $17K | — | $17K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF NEW YORK EIN 11-1980218 NONE | Contract Administrator Service code 13 | — | $27K |
| BUCHBINDER TUNICK & COMPANY LLP EIN 13-1578842 NONE | Accounting (including auditing) Service code 10 | — | $13K |
| MILLIMAN, INC EIN 91-0675641 NONE | Actuarial Service code 11 | — | $6K |
| MICHAEL JACOBSON EIN 11-2516673 NONE | Accounting (including auditing) Service code 10 | — | $5K |
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 | 348 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE HARTFORD | 349 | $119K |
| Long-term disability | THE HARTFORD | 347 | $83K |
| Other | THE HARTFORD | 349 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 349 | — |
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.