| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R C LAIN INC.3 | PO BOX 1117 PORT JERVIS, NY 12771 | SUN LIFE ASSURANCE COMPANY OF CANADA | $23K | — | $23K | 3.50% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GEN'L AGEN | 400 BERWYN PARK STE 200 BERWYN, PA 19312 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | — | $10K | 1.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA EIN 06-6033492 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $163K |
| GIANCARLO PREZIOSO EIN 22-1594458 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| PAUL A. MONTALBANO, ESQ., LLC EIN 04-3669184 ATTORNEY FOR LOCAL 701 | Legal; Direct payment from the plan Service code 29 | — | $65K |
| MARY JO MIESZKUC EIN 22-1594458 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $64K |
| NILSA LAKE EIN 22-1594458 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $63K |
| CBIZ SAVITZ EIN 31-1582098 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $48K |
| PHOENIX BENEFITS MANAGMENT EIN 45-3250131 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $43K |
| ROBERT MCMAHON EIN 22-1594458 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $29K |
| MSPC EIN 22-2951202 ACCOUNTANT FOR LOCAL 701 | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $22K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $19K |
| SCRIPTA INSIGHTS, INC. EIN 83-3003502 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $17K |
| ANTHONY SIDOTI EIN 22-1594458 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $12K |
| ERNEST SOEHL EIN 22-1594458 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $12K |
| LAMAR BEINHOWER EIN 22-1594458 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $12K |
| KEVIN J. DEMBINSKI, DMD EIN 22-2198817 NONE | Other services; Direct payment from the plan Service code 49 | — | $10K |
| TEAMSTERS CENTER SERVICES FUND NONE | Direct payment from the plan; Other services Service code 49 | 121 W 27TH STREET, 601 NEW YORK, NY 10001 | $6K |
| NEPC, LLC NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $6K |
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 | 275 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 98 | $174K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 199 | $662K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 98 | $174K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.