| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 333 WEST 34TH STREET NEW YORK, NY 10001 | GRANULAR INSURANCE COMPANY | $83K | — | $83K | 4.63% |
| ACRISURE LLC3 Filed as: ACRISURE PGM INSURANCE SERVICES | 311 CLOCK TOWER COMMONS DR BREWSTER, NY 10509 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 6.01% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER COMMONS DR BREWSTER, NY 10509 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON BC/BS OF NJ EIN 22-0999690 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $3.0M |
| EMPIRX HEALTH, LLC EIN 47-1226691 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $1.9M |
| PAYER MATRIX LLC EIN 81-3946362 NONE | Other services; Direct payment from the plan Service code 49 | — | $1.7M |
| GLENN DIBIASI EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $395K |
| THE SEGAL COMPANY EIN 06-0839113 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $378K |
| GREEN LIGHT COST MANAGEMENT LLC EIN 45-5248276 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $367K |
| CONIFER VALUE BASED CARE LLC EIN 52-1964905 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $326K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $289K |
| SLEVIN & HART PC EIN 52-1708613 NONE | Legal; Direct payment from the plan Service code 29 | — | $254K |
| BRENDA GARMA EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $178K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 20-8764829 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $145K |
| HEALTHSMART CARE MANAGEMENT SOLUTIO EIN 20-1504892 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $144K |
| DELTA DENTAL OF NEW JERSEY EIN 22-1896118 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $131K |
| BROWN & BROWN OF MASSACHUSETTS EIN 27-4732361 NONE | Other services; Direct payment from the plan Service code 49 | — | $125K |
| HYACINTH JOHNSON EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $119K |
| DONNA SPERONE EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $119K |
| RENA SVOKOS EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $116K |
| ROBIN GOODMAN EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $113K |
| SUANNE MCCORMACK EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $112K |
| JOANN THEURET EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $111K |
| ROBIN PEREZ EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $111K |
| SAVITA GANDOTRA EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $111K |
| MARISELA V RUIZ EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $107K |
| BBH SOLUTIONS, INC. EIN 11-2982889 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $103K |
| NATALINA MEDINA EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $101K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $99K |
| DAWN QUINN EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $98K |
| NANDINA VALENCIA NOWICKI EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $97K |
| MONICA RODRIGUEZ EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| LAURA MARTE EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| TRACEY RUTAN EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $92K |
| PEDRO GONZALEZ EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| KAREN CHAN EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| SUSAN STUCKEY EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| LUZ RODRIGUEZ EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| EMILY TON EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| PEGGIE MORGAN EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| SVAM INTERNATIONAL, INC. EIN 11-3190965 NONE | Direct payment from the plan; Other services Service code 49 | — | $83K |
| MELISSA JAIMES EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $81K |
| EBONY MCCULLAM EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $80K |
| MARCIA GRAHAM EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| JUAN PACHECO EIN 22-1458594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $76K |
| HAYDELIZA JAVIER-SANTOS EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $75K |
| MELINDA NYE ROMAINE EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| KAREN BUCHANAN EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $65K |
| LARRY MAGARIK, ESQ EIN 46-4963823 NONE | Legal; Direct payment from the plan Service code 29 | — | $62K |
| GALLAGHER BENEFIT SERVICES INC EIN 36-4291971 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $54K |
| MFS INVESTMENT MANAGEMENT EIN 04-2747644 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $54K |
| CINDY HERNANDEZ EIN 22-1458594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $51K |
| DR. ANITA NISCHAL NONE | Consulting (general); Direct payment from the plan Service code 16 | 200 PERRINE RD STE 230 OLD BRIDEG, NJ 08857 | $48K |
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 | 9,018 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 476 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 9,494 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 71 | $47K |
| Stop-loss / reinsurancereinsurance | GRANULAR INSURANCE COMPANY | 9,541 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,541 | — |
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.