| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC MADISON PARTNERS INSU | 100 OTTAWA AVENUE, SW GRAND RAPIDS, MI 49503 | AMALGAMATED LIFE INSURANCE COMPANY | $463 | — | $463 | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMALGAMATED EMPLOYEE BEN ADMIN EIN 13-3432221 CLAIMS ADMINISTRATION | Contract Administrator; Direct payment from the plan Service code 13 | 333 WESTCHESTER AVE WHITE PLAINS, NY 10604 | $98K |
| ANTHEM BLUE CROSS (G1921) EIN 23-7391136 | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Claims processing Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $96K |
| PETER VAUPEL EIN 13-6179467 FUND ADMINISTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | 629 FIFTH AVENUE PELHAM, NY 10803 | $81K |
| CITRIN COOPERMAN & COMPANY, LLP EIN 22-2428965 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 100 JERICHO QUADRANGLE STE 342 JERICHO, NY 11753 | $27K |
| BARNES, IACCARINO & SHEPHERD LLP EIN 26-3858697 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 3 SURREY LANE HEMPSTEAD, NY 11550 | $22K |
| CYNOMYS, INC. EIN 82-2668930 ACTUARIAL | Direct payment from the plan Service code 50 | 16170 POPPY SEED CIRCLE UNIT 902 DELRAY BEACH, FL 33484 | $20K |
| EDUARDO MELENDEZ EIN 13-6179467 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 629 FIFTH AVENUE PELHAM, NY 10803 | $12K |
| AMALGAMATED MEDICAL CARE MANAGEMENT EIN 13-3860528 | Direct payment from the plan; Other services Service code 49 | 1 NORTHEASTERN BLVD,SUITE 100 SALEM, NH 03079 | $11K |
| DAHAB ASSOCIATES EIN 11-2783874 INVESTMENT CONSULTANT | Consulting (general); Investment management fees paid directly by plan Service code 16 | 423 SOUTH COUNTRY ROAD BAY SHORE, NY 11706 | $8K |
| D. D. SERVICES, INC. EIN 11-2705347 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | 265 POST AVENUE, SUITE 340 WESTBURY, NY 11590 | $7K |
| M&T BANK TRUST & PENSION SERVICES EIN 16-0538020 INVESTMENT CUSTODIAN | Investment management fees paid directly by plan; Custodial (securities) Service code 19 | 285 DELAWARE AVE, 3RD FLOOR BUFFALO, NY 14202 | $6K |
| EKA BENEFITS INC EIN 92-1309853 STOP LOSS MARKETING | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 157 E. MAIN STREET HUNTINGTON, NY 11743 | $0 |
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 | 288 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 411 | $8K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE COMPANY | 288 | $462K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 411 | — |
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.