| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAKESHORE BENEFIT GROUP INSURANCE | 529 MAIN STREET SUITE 2B NEW HARTFORD, CT 06057 | GERBER LIFE INSURANCE COMPANY | $33K | — | $33K | 16.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| I.E. SHAFFER & CO. EIN 22-1750854 NONE | Contract Administrator Service code 13 | — | $530K |
| VANGUARD INSTITUTION INVESTOR SERVI EIN 23-7825314 NONE | Investment advisory (plan) Service code 27 | — | $95K |
| ENVISION EIN 05-0570786 NONE | Contract Administrator Service code 13 | — | $55K |
| UBS FINANCIAL SERVICES EIN 13-2638166 NONE | Custodial (securities) Service code 19 | — | $39K |
| LINDABURY, MCCORMICK EIN 22-1943351 NONE | Legal Service code 29 | — | $38K |
| MSPC CERTIFIED PUBLIC ACCOUNTANTS EIN 22-2951202 NONE | Accounting (including auditing) Service code 10 | — | $34K |
| PRINCETON HEALTHCARE SYSTEMS EIN 21-0635009 NONE | Other services Service code 49 | 1000 HERRONTOWN RD CLOCK BLDG. PRINCETON, NJ 08540 | $34K |
| KROLL & HEINEMAN EIN 22-2897879 NONE | Legal Service code 29 | — | $20K |
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 | 802 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 437 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE UNION LABOR OF LIFE INSURANCE COMPANY | 790 | $56K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE COMPANY | 885 | $196K |
| Other | THE UNION LABOR OF LIFE INSURANCE COMPANY | 790 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 885 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.