| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHICAGO BENEFIT CONSULTANTS INC.3 | 1236 BRACE RD UNIT E CHERRY HILL, NJ 08034 | EXCELLUS | $39K | — | $39K | 3.03% |
| LIFETIME BENEFIT SOLUTIONS, INC.3 | 2457 STATE RT 7 SUITE 1 PO BOX 340 COBLESKILL, NY 12043 | EXCELLUS | $14K | — | $14K | 1.10% |
| LABOR FIRST LLC3 Filed as: LABOR-FIRST LLC | 1000 MIDLANTIC DRIVE SUITE 100 MOUNT LAUREL, NJ 080541511 | HUMANA INSURANCE COMPANY OF NEW YORK | $590 | — | $590 | 1.06% |
| UPSTATE FINANCIAL SERVICES3 | 2105 W GENESEE STREET SUITE 115 SYRACUSE, NY 13219 | HUMANA INSURANCE COMPANY OF NEW YORK | $236 | — | $236 | 0.42% |
| LABOR FIRST LLC3 Filed as: LABOR-FIRST LLC | 1000 MIDLANTIC DRIVE SUITE 100 MOUNT LAUREL, NJ 080541511 | HUMANA INSURANCE COMPANY | $160 | — | $160 | 1.19% |
| UPSTATE FINANCIAL SERVICES3 | 2105 W GENESEE STREET SUITE 115 SYRACUSE, NY 13219 | HUMANA INSURANCE COMPANY | $64 | — | $64 | 0.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASHLEY TILEBEIN EIN 16-6058900 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $31K |
| TRONCONI SEGARRA & ASSOCIATES LLP EIN 04-3728817 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $24K |
| LIPSITZ GREEN SCIME CAMBRIA EIN 16-0905097 NONE | Legal; Direct payment from the plan Service code 29 | — | $24K |
| PIERCE PARK GROUP EIN 51-0311895 NONE | Investment management; Direct payment from the plan Service code 28 | — | $18K |
| ARCARA LENDA EUSANIO & STACY CPAS EIN 47-1793720 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $16K |
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 | 79 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | EXCELLUS | 84 | $1.4M |
| Prescription drug | EXCELLUS | 84 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 84 | — |
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.