| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NORTH AMERICAN BENEFITS COMPANY5 | 20 VALLEY STREAM PARKWAY, SUITE 310 MALVERN, PA 19355 | MADISON NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 7.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $817K |
| EMPIRX HEALTH EIN 47-1226691 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $576K |
| CATHERINE OAKES EIN 22-1644608 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $97K |
| COHEN, LEDER, MONTALBANO & CONNAUGH EIN 41-2043615 ATTY FOR LOCAL 125 | Legal; Direct payment from the plan Service code 29 | — | $55K |
| MARY MCGAHA EIN 22-1644608 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| ANTONIO PETILLO EIN 22-1644608 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $51K |
| MSPC EIN 22-2951202 ACCT FOR LOCAL 125 | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $47K |
| LYNN THOMSON EIN 22-1644608 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $43K |
| JENNIFER CHERMAK EIN 22-1644608 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $40K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $38K |
| O'SULLIVAN ASSOCIATES, INC. EIN 20-8199367 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $30K |
| ATALANTA SOSNOFF CAPITAL, LLC EIN 20-0461050 NONE | Investment management fees paid directly by plan Service code 51 | — | $24K |
| DEALY & SILBERSTEIN, LLP EIN 46-0507412 NONE | Legal; Direct payment from the plan Service code 29 | — | $19K |
| AMERICAN REALTY ADVISORS EIN 33-0123114 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $15K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $12K |
| NATIONAL VISION ADMINISTRATORS, LLC EIN 74-3033381 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $7K |
| INVESTMENT PERFORMANCE SERVICES LLC EIN 58-2432390 NONE | Investment advisory (plan); Consulting (general); Investment management fees paid directly by plan Service code 16 | — | $7K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $0 |
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 | 1,678 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,682 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE CO. | 2,712 | $834K |
| Life insurance | MADISON NATIONAL LIFE INSURANCE COMPANY | 1,668 | $66K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE COMPANY | 0 | $1.2M |
| Other | MADISON NATIONAL LIFE INSURANCE COMPANY | 1,668 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,712 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.