| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD, 2ND FLR HAUPPAUGE, NY 11788 | HARTFORD LIFE AND ACCIDENT | $50K | $25K | $76K | 15.00% |
| HJ KNIGHT INTERNATIONAL3 | 30 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | HCC LIFE INSURANCE | $19K | — | $19K | 8.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DISTRTICT 1199J PENSION PLAN EIN 22-3095464 AFFLIATED BENEFIT FUND | Other services; Direct payment from the plan Service code 49 | — | $1.2M |
| HORIZON HEALTHCARE SERVICES EIN 22-0999690 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $1.2M |
| MILLIMAN INC EIN 91-0675641 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $133K |
| OXFELD COHEN EIN 01-0725849 NONE | Legal; Direct payment from the plan Service code 29 | — | $92K |
| SELE DENT EIN 11-3310187 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $87K |
| FOX ROTHSCHILD LLP EIN 23-1404723 NONE | Legal; Direct payment from the plan Service code 29 | — | $74K |
| SAXBST LLP EIN 46-4001827 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $64K |
| SYNTONIC SYSTEMS INC EIN 13-2925049 NONE | Other services; Direct payment from the plan Service code 49 | — | $46K |
| EXPRESS SCRIPTS INC EIN 22-3461740 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $44K |
| ROLANDO Y HONG, MD NONE | Other services; Direct payment from the plan Service code 49 | 13 FAIRMOUNT AVE UPPER MOUNTCLAIR, NJ 07043 | $39K |
| WELLS FARGO BANK EIN 41-0449260 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $32K |
| MITCHELL J MALZBERG LLC NONE | Legal; Direct payment from the plan Service code 29 | 6 E MAIN ST, STE 7 CLINTON, NJ 08809 | $19K |
| PAYCHEX INC EIN 16-1124166 NONE | Other services; Direct payment from the plan Service code 49 | — | $8K |
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 | 2,771 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,793 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 4,656 | $504K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE | 3,382 | $225K |
| Other | HARTFORD LIFE AND ACCIDENT | 4,656 | $504K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,656 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.