| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES | 1000 WOODBURY RD STE 403 WOODBURY, NY 11797 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $4K | $4K | 0.83% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING | 110 MAIN ST POUGHKEEPSIE, NY 12601 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | — | $1K | 0.25% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES | 1000 WOODBURY RD STE 403 WOODBURY, NY 11797 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $2K | $2K | 0.65% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING | 110 MAIN ST POUGHKEEPSIE, NY 12601 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | — | $2K | 0.43% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES | 1000 WOODBURY RD STE 403 WOODBURY, NY 11797 | COMPANION LIFE INSURANCE COMPANY | — | $2K | $2K | 0.98% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING | 110 MAIN ST POUGHKEEPSIE, NY 12601 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 0.83% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING | 110 MAIN ST POUGHKEEPSIE, NY 12601 | ANTHEM BLUE CROSS AND BLUE SHIELD | $3K | $1K | $4K | 6.97% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING | 110 MAIN ST POUGHKEEPSIE, NY 12601 | MUTUAL OF OMAHA INSURANCE COMPANY | $829 | — | $829 | 4.99% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES | 1000 WOODBURY RD STE 403 WOODBURY, NY 11797 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $138 | $138 | 0.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS AND BLUE SHIELD EIN 23-7391136 | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $592K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Plan Administrator; Claims processing Service code 12 | — | $476K |
| SEI INVESTMENT MANAGEMENT CORP. EIN 23-1707341 NONE | Contract Administrator; Custodial (securities) Service code 13 | — | $346K |
| MARSHALL & STERLING EMPLOYEE BENEFI EIN 14-1769291 | Claims processing Service code 12 | — | $307K |
| SLEVIN & HART, P.C. EIN 52-1708613 NONE | Legal Service code 29 | — | $182K |
| KEYBANK NATIONAL ASSOCIATION EIN 34-1974250 NONE | Shareholder servicing fees; Custodial (securities) Service code 19 | — | $59K |
| TEAL, BECKER AND CHIARAMONTE, CPAS EIN 14-1624930 NONE | Accounting (including auditing) Service code 10 | — | $47K |
| BOLTON PARTNERS NORTHEAST, INC. EIN 27-3666661 NONE | Actuarial Service code 11 | — | $25K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Accounting (including auditing) Service code 10 | — | $12K |
| BLITMAN & KING LLP EIN 16-1047304 NONE | Legal Service code 29 | — | $8K |
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 | 1,192 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 202 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 399 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,793 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ANTHEM BLUE CROSS AND BLUE SHIELD | 1,617 | $56K |
| Vision | ANTHEM BLUE CROSS AND BLUE SHIELD | 1,617 | $56K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 1,693 | $205K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 1,094 | $505K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 1,101 | $355K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE CO. | 1,112 | $680K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 1,107 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,693 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.