| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | — | $19K | $19K | 24.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $659K |
| JENNINGS SIGMOND P.C. EIN 23-2025670 NONE | Legal; Direct payment from the plan Service code 29 | — | $138K |
| LABOR FIRST EIN 06-1750191 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $112K |
| NANCY ADDEZZIO EIN 21-0699966 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $108K |
| SHERRY RASO EIN 21-0699966 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $98K |
| CONNOR STRONG & BUCKELEW COMPANIES EIN 21-0718159 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $84K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $72K |
| JOHN SHALOO EIN 21-0699966 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $68K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 15 | — | $67K |
| SMITH GRAHAM & CO. INVESTMENT ADVIS EIN 76-0301817 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $52K |
| JACKIE SWANSON EIN 21-0699966 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $48K |
| THE MCKEOGH COMPANY EIN 23-3003375 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $35K |
| PNC BANK EIN 22-1146430 NONE | Direct payment from the plan; Investment management; Investment management fees paid directly by plan Service code 28 | — | $30K |
| PATTI DUBOSQUE EIN 21-0699966 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $30K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $19K |
| PAYCHEX EIN 16-1124166 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $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 | 648 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 730 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,378 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION BENEFITS OF AMERICA | 1,373 | $91K |
| Life insurance | USABLE LIFE | 1,181 | $76K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE | 1,378 | $774K |
| Other(2 contracts, 2 carriers) | UNITED AMERICAN INSURANCE COMPANY | 1,181 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,378 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.