| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BOLTON PARTNERS NORTHEAST, INC. | 9000 MID ALANTIC DRIVE, MT. LAUREL, NJ 08054 | THE UNION LABOR LIFE INSURANCE COMPANY | $7K | — | $7K | 3.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL DISTRICT PHYSICIAN'S HEALTH EIN 14-1641028 NONE | Claims processing Service code 12 | 500 PATROON CREEK BLVD ALBANY, NY 12206 | $140K |
| CHRISTOPHER BAXTER EIN 14-1418020 EMPLOYEE | Employee (plan) Service code 30 | 37 LUZERNE ROAD QUEENSBURY, NY 12801 | $93K |
| KETHEM NOVICK EIN 14-1418020 EMPLOYEE | Employee (plan) Service code 30 | 37 LUZERNE ROAD QUEENSBURY, NY 12804 | $69K |
| ATALANTA SOSNOFF EIN 20-0461050 NONE | Investment management Service code 28 | 505 5TH AVENUE, 17TH FLOOR NEW YORK, NY 10017 | $59K |
| BOLTON PARTNERS NORTHEAST, INC. EIN 27-3666661 NONE | Actuarial Service code 11 | 2277 STATE HIGHWAY 33 SUITE 409 TRENTON, NJ 08690 | $41K |
| BOSTON PARTNERS EIN 98-0202744 NONE | Investment management Service code 28 | 1 BEACON STREET 30TH FLOOR BOSTON, MA 02108 | $37K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Claims processing Service code 12 | PO BOX 52150 PHOENIX, AZ 85072 | $34K |
| MERRILL LYNCH EIN 13-5674085 NONE | Sub-transfer agency fees; Securities brokerage; Investment management; Custodial (other than securities) Service code 18 | 250 VESEY STREET NEW YORK, NY 10281 | $32K |
| LOOMIS SAYLES EIN 04-3200030 NONE | Investment management Service code 28 | 1384 OLD FREEPORT ROAD, SUITE A2 PITTSBURGH, PA 15238 | $26K |
| JOSEPH W. MCCARTHY & ASSOCS. SPECIA EIN 16-1120588 NONE | Accounting (including auditing) Service code 10 | 7644 RT. 31 WEST BALDWINSVILLE, NY 13027 | $15K |
| D'ARCANGELO & CO., LLP EIN 13-2550103 NONE | Accounting (including auditing) Service code 10 | 120 LOMOND COURT UTICA, NY 13502 | $15K |
| POZEFSKY, BRAMLEY & MURPHY EIN 14-1601487 NONE | Legal Service code 29 | 90 STATE STREET ALBANY, NY 12207 | $14K |
| KRAKOW, SOURIS & LANDRY EIN 04-3363718 NONE | Legal Service code 29 | 225 FRIEND STREET BOSTON, MA 02114 | $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 | 337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 70 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 0 | $106K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 262 | $191K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.