| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN BLASCH | 71 BEECHWOOD LANE BERKELEY HEIGHTS, NJ 07922 | HARTFORD LIFE AND ACCIDENT | $25K | $13K | $37K | 15.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES EIN 22-0999690 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $1.5M |
| DISTRICT 1199J PENSION PLAN EIN 22-3095464 AFFLIATED BENEFIT FUND | Direct payment from the plan; Other services Service code 49 | — | $438K |
| PAYER MATRIX LLC EIN 81-3946362 NONE | Direct payment from the plan; Other services Service code 49 | — | $180K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $141K |
| LAW OFFICES OF BRIAN D SULLIVAN EIN 86-2988539 NONE | Legal; Direct payment from the plan Service code 29 | — | $105K |
| OXFELD COHEN PC EIN 01-0725849 NONE | Legal; Direct payment from the plan Service code 29 | — | $90K |
| SELE DENT EIN 11-3310187 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $81K |
| GALLAGHER BENEFIT SERVICES, INC. EIN 36-4291971 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $75K |
| PRECIOSA LAVRADOR EIN 22-3143027 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $57K |
| MARIBEL NEGRON EIN 22-3143027 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $55K |
| MICHELE KAMAL EIN 22-3143027 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $49K |
| MICHAEL PISANI EIN 22-3143027 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $49K |
| MILLIMAN INC EIN 91-0675641 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $48K |
| JORGE SARDINAS EIN 22-3143027 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $46K |
| GUILLERMO TINEO EIN 22-3143027 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $46K |
| SYNTONIC SYSTEMS INC EIN 13-2925049 NONE | Other services; Direct payment from the plan Service code 49 | — | $44K |
| PRIYANKA PATEL EIN 22-3143027 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $42K |
| DONNA HUGHES EIN 22-3143027 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $37K |
| EMPIRX HEALTH, LLC EIN 47-1226691 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $35K |
| JENNIFER EBEL EIN 22-3143027 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $34K |
| ANA SILVA EIN 22-3143027 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $33K |
| ROSE ANN GONZALEZ EIN 22-3143027 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| LOUIS SOTO EIN 22-3143027 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $31K |
| ORLANDO HURTADO EIN 22-3143027 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $29K |
| CHRISTINA PACHECO EIN 22-3143027 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $28K |
| SHALYN RODRIGUES EIN 22-3143027 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $25K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $13K |
| PAYCHEX INC EIN 16-1124166 NONE | Direct payment from the plan; Other services Service code 49 | — | $13K |
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 | 2,945 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,947 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 3,165 | $245K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE | 2,184 | $316K |
| Other | HARTFORD LIFE AND ACCIDENT | 3,165 | $245K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,165 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.