| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENV INSURANCE AGENCY LLC Filed as: ENV INSURANCE AGENCY, LLC. | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | HCC LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| POMCO, INC. EIN 15-0381548 NONE | Claims processing Service code 12 | — | $109K |
| BLITMAN AND KING EIN 16-1047304 NONE | Insurance agents and brokers Service code 22 | — | $71K |
| LIFETIME BENEFIT SOLUTIONS EIN 16-1171765 NONE | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $70K |
| CORPORATE CARE MANAGEMENT EIN 16-1181119 NONE | Consulting (pension) Service code 17 | — | $40K |
| TARA DENUCCI EIN 16-6053348 EMPLOYEE | Contract Administrator Service code 13 | — | $38K |
| O'SULLIVAN ASSOCIATES EIN 20-8199367 NONE | Actuarial Service code 11 | — | $34K |
| JOSEPH MCCARTHY EIN 16-1120588 NONE | Other services Service code 49 | — | $12K |
| POMCO PLUS, LLC EIN 45-0482796 NONE | Insurance services Service code 23 | — | $0 |
| PRIVATE HEALTHCARE SYSTEMS EIN 13-3068979 NONE | Contract Administrator Service code 13 | — | $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 | 324 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 220 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 544 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 404 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 404 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.