| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | — | $10K | $10K | 23.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JENNINGS SIGMOND P.C. EIN 23-2025670 NONE | Legal; Direct payment from the plan Service code 29 | — | $115K |
| NANCY ADDEZZIO EIN 21-0699966 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| SHERRY RASO EIN 21-0699966 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| CONNOR STRONG & BUCKELEW COMPANIES EIN 21-0718159 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $65K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $64K |
| SMITH GRAHAM & CO. INVESTMENT ADVIS EIN 76-0301817 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $55K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $46K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $43K |
| JACKIE SWANSON EIN 21-0699966 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $41K |
| JOHN SHALOO EIN 21-0699966 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $37K |
| THE MCKEOGH COMPANY EIN 23-3003375 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $30K |
| PATTI DUBOSQUE EIN 21-0699966 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $25K |
| PNC BANK EIN 23-7801736 NONE | Investment management fees paid directly by plan; Custodial (securities); Investment management; Direct payment from the plan Service code 19 | — | $20K |
| IE SHAFFER & CO EIN 22-1750854 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $20K |
| LABOR FIRST NONE | Consulting (general); Direct payment from the plan Service code 16 | 3000 MIDLANTIC DRIVE - STE 101 MT. LAUREL, NJ 08054 | $18K |
| EPIC HEARING NONE | Claims processing Service code 12 | 3191 W TEMPLE AVE - STE 200 POMONA, CA 91768 | $10K |
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 | 722 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 753 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,475 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | AMERIHEALTH | 1,475 | $14.6M |
| Vision | VISION BENEFITS OF AMERICA | 1,340 | $88K |
| Life insurance | USABLE LIFE | 1,113 | $44K |
| Other | USABLE LIFE | 1,113 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,475 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.