| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MILLER INSURANCE BROKERAGE3 Filed as: MILLER INSURANCE BROKERAGE, INC. | 12318 S. CIERO AVE ALSIP, IL 60803 | AMALGAMATED LIFE INSURANCE COMPANY | $25K | — | $25K | 7.50% |
| BUCKINGHAM INSURANCE SERVICES, INC.3 | 301 HYDE PARK DOYLESTOWN, PA 18902 | MUNICH REINSURANCE AMERICA, INC. | $19K | — | $19K | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $215K |
| LEONARD RICHMAN EIN 22-1522177 NONE | Plan Administrator Service code 14 | — | $58K |
| PHOENIX PBM NONE | Claims processing Service code 12 | — | $31K |
| BUCHBINDER TUNICK & CO. LLP EIN 13-1578842 NONE | Accounting (including auditing) Service code 10 | — | $25K |
| ORANSKY, SCARAGGI & BORG, PC EIN 22-3522685 NONE | Legal Service code 29 | — | $10K |
| APPLIED BUSINESS SYSTEMS EIN 22-2875533 NONE | Consulting (general) Service code 16 | — | $8K |
| MEDTRAK SERVICES EIN 36-4221427 NONE | Claims processing Service code 12 | — | $7K |
| MICHAEL A JACOBSON, CPA EIN 11-2516673 ACCOUNTANT OF RELATED ORG | Accounting (including auditing) Service code 10 | — | $5K |
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 | 389 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 389 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HEALTHPLEX INSURANCE COMPANY | 399 | $197K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AMALGAMATED LIFE INSURANCE COMPANY | 401 | $651K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 401 | — |
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.
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.