| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDWARD JOSEPH CHICOSKI | 301 ALBANY TURNPIKE CANTON, CT 06019 | AETNA HEALTH, INC. | $6K | — | $6K | 2.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BASIL CASTROVINCI ASSOCIATES EIN 13-2831500 NONE | Plan Administrator Service code 14 | 36 HOPATCHUNG ROAD HOPATCONG, NJ 07843 | $252K |
| AETNA EIN 06-0843888 NONE | Claims processing Service code 12 | 9 ENTIN ROAD PARSIPPANY, NJ 07054 | $195K |
| DAVIS VISION, INC EIN 11-3051991 NONE | Claims processing Service code 12 | 175 E HOUSTON STREET SAN ANTONIO, TX 78205 | $81K |
| DA GERSON, CPA & ASSOCIATES, PC EIN 22-3163246 NONE | Accounting (including auditing) Service code 10 | 201 WEST PASSAIC STREET ROCHELLE PARK, NJ 07662 | $31K |
| TIMOTHY HOTT, ESQ. EIN 22-3724341 NONE | Legal Service code 29 | 100 CHALLENGER ROAD RIDGEFIELD PARK, NJ 07760 | $13K |
| LINDABURY, MCCORMICK, ESTABROOK EIN 22-1943551 NONE | Legal Service code 29 | 53 CARDINAL DRIVE WESTFIELD, NJ 07091 | $11K |
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 | 303 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 350 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 654 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | AETNA HEALTH, INC. | 425 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 425 | — |
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.