| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BOLTON PARTNERS NORTHEAST, INC. | 9000 MID ATLANTIC DRIVE MOUNT LAUREL, NJ 08054 | THE UNION LABOR LIFE INSURANCE COMPANY | $3K | — | $3K | 3.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 2425 JAMES STREET SYRACUSE, NY 13206 | $127K |
| MANNING & NAPIER EIN 16-0995736 NONE | Investment management; Soft dollars commissions Service code 28 | 290 WOODCLIFF DRIVE FAIRPORT, NY 14450 | $109K |
| BLITMAN AND KING EIN 16-1047304 NONE | Legal Service code 29 | 443 NORTH FRANKLIN STREET SYRACUSE, NY 13204 | $58K |
| AMBER LOPICCOLO EIN 15-0626264 EMPLOYEE | Employee (plan) Service code 30 | 142 CORPORATE DRIVE BINGHAMTON, NY 13904 | $50K |
| HOLLY NELSON EIN 15-0626264 EMPLOYEE | Employee (plan) Service code 30 | 142 CORPORATE DRIVE BINGHAMTON, NY 13904 | $30K |
| BOLTON PARTNERS NORTHEAST, INC EIN 27-3666661 NONE | Actuarial Service code 11 | 2277 STATE HIGHWAY 33 TRENTON, NJ 08690 | $28K |
| KEENAN & ASSOCIATES EIN 95-2798626 NONE | Consulting (general) Service code 16 | 2355 CRENSHAW BLVD. SUITE 200 TORRANCE, CA 90501 | $26K |
| D'ARCANGELO & CO., LLP EIN 13-2550103 NONE | Accounting (including auditing) Service code 10 | 120 LOMOND COURT UTICA, NY 13502 | $17K |
| INVESTMENT PERFORMANCE SERVICES, LL NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | PO BOX 9510 SAVANNAH, GA 31412 | $14K |
| TELEDOC NONE | Contract Administrator Service code 13 | 2 MANHATTANVILLE ROAD PURCHASE, NY 10577 | $14K |
| ENV INSURANCE AGENCY EIN 16-1519815 BROKER | Other commissions Service code 55 | 7789 OSWEGO RD. LIVERPOOL, NY 13090 | $6K |
| LABOR FIRST, LLC EIN 06-1750191 NONE | Contract Administrator Service code 13 | 1000 MIDLANTIC DRIVE, SUITE 100 MOUNT LAURET, NJ 08054 | $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 | 273 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 51 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 324 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | THE UNION LABOR LIFE INSURANCE COMPANY | 251 | $104K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 225 | $224K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 251 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.