| 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 | $65K | — | $65K | 12.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing Service code 12 | — | $337K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $306K |
| ANA TANG EIN 13-6129427 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $125K |
| TARTER, KRINSKY & DROGIN, LLP EIN 13-4160916 NONE | Legal; Direct payment from the plan Service code 29 | — | $114K |
| ANA MENDOZA EIN 13-6129427 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $81K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $73K |
| AMALGAMATED MEDICAL MANAGEMENT, INC EIN 13-3432221 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $57K |
| FIRST ACTUARIAL CONSULTING INC. EIN 26-3842522 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $54K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $54K |
| UNITED HEALTHCARE INSURANCE CO. EIN 41-2014834 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $32K |
| TEAMSTER CENTER SERVICES EIN 13-1964856 NONE | Other services; Direct payment from the plan Service code 49 | — | $29K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $11K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $10K |
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 | 1,127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 1,127 | $340K |
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 653 | $16K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,131 | $530K |
| Other | AMALGAMATED LIFE INSURANCE COMPANY | 12 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,131 | — |
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.