| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HORIZON INSURANCE COMPANY Filed as: HORIZON HEALTHCARE INS AGY INC | 3 PENN PLZ E NEWARK, NJ 071052258 | SYMETRA LIFE INSURANCE COMPANY | $0 | $12K | $12K | 1.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES EIN 22-0999690 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $240K |
| ACRISURE EIN 26-3554645 NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $74K |
| CATHERINE SOMA EIN 22-1552880 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $47K |
| SUSANIN WIDMAN & BRENNAN, PC EIN 23-2265950 NONE | Legal; Direct payment from the plan Service code 29 | — | $45K |
| MARTHA DEFAZIO EIN 22-1552880 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $39K |
| MSPC EIN 22-2951202 ACCT FOR LOCAL 469 | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $37K |
| MARIA CATENACCI EIN 22-1552880 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $37K |
| CHARTWELL INVESTMENT PARTNERS, LP EIN 36-4776242 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $34K |
| NORTHSHORE INTERNATIONAL INS. SVCS. NONE | Direct payment from the plan; Consulting (general) Service code 16 | 199 ROSEWOOD DR., STE 310 DANVERS, MA 01923 | $30K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $26K |
| O'SULLIVAN ASSOCIATES, INC EIN 20-8199367 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $21K |
| TIMOTHY R. HOTT, P.C. EIN 22-3724341 ATTY FOR LOCAL 469 | Legal; Direct payment from the plan Service code 29 | — | $20K |
| DELTA DENTAL OF NJ, INC. EIN 22-1896118 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $14K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Float revenue; Direct payment from the plan; Other fees; Claims processing Service code 12 | — | $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 | 670 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 687 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 444 | $26K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 686 | $897K |
| Other | HARTFORD LIFE AND ACCIDENT | 444 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 686 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.