| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FAIRVIEW INSURANCE AGENCY Filed as: FAIRVIEW ASSOCIATES | 25 FAIRVIEW AVE VERONA, NJ 07044 | HORIZON HEALTHCARE SERVICES INC | $18K | — | $18K | 3.21% |
| HORIZON INSURANCE COMPANY | 3 PENN PLAZA EAST NEWARK, NJ 07105 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 3.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARES SERVICES INC. EIN 22-0999690 NONE | Claims processing; Contract Administrator Service code 12 | — | $2.3M |
| UBS FINANCIAL SERVICES INC EIN 13-2638166 NONE | Securities brokerage commissions and fees; Distribution (12b-1) fees; Investment advisory (plan) Service code 27 | — | $483K |
| LOCAL 68 ENG UNION EDUCATION FD EIN 22-6066637 AFFILIATED FUND | Contract Administrator Service code 13 | — | $225K |
| VICTOR LOPEZ EIN 22-1550500 EMPLOYEE | Employee (plan) Service code 30 | — | $101K |
| BRIDGEWAY BENEFIT TECHNOLOGIES NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 3000 S. LENOLA RD MAPLE SHADE, NJ 08052 | $70K |
| WELLS FARGO ADVISORS EIN 34-1542819 NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | — | $62K |
| CHRISTOPHER RUTON EIN 22-1550500 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| KATHLEEN IANDIORIO EIN 22-1550500 EMPLOYEE | Employee (plan) Service code 30 | — | $42K |
| KIMBERLY HAMILTON EIN 22-1550500 EMPLOYEE | Employee (plan) Service code 30 | — | $39K |
| MARY ANNE WOJTAL EIN 22-1550500 EMPLOYEE | Employee (plan) Service code 30 | — | $39K |
| PATRICIA DANDOLA EIN 22-1550500 EMPLOYEE | Employee (plan) Service code 30 | — | $39K |
| THERESA EAGEN EIN 22-1550500 EMPLOYEE | Employee (plan) Service code 30 | — | $38K |
| MSPC EIN 22-2951202 NONE | Accounting (including auditing) Service code 10 | — | $35K |
| WASILEWSKI & KEATING P.C. EIN 22-2676761 NONE | Accounting (including auditing) Service code 10 | — | $30K |
| CVS PHARMACY INC EIN 05-0340626 NONE | Claims processing Service code 12 | — | $26K |
| ORANSKY SCARAGGI & BORG P.C. EIN 22-3522685 NONE | Legal Service code 29 | — | $23K |
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 | 2,094 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,094 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 2,094 | $137K |
| Stop-loss / reinsurancereinsurance | HORIZON HEALTHCARE SERVICES INC | 2,094 | $562K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,094 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.