| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAKESHORE BENEFIT GROUP INSURANCE3 Filed as: LAKESHORE BENEFIT GROUP | 301 ALBANY TURNPIKE CANTON, CT 06019 | AMALGAMATED LIFE INSRUANCE COMPANY | $38K | — | $38K | 8.00% |
| LAKESHORE BENEFIT GROUP INSURANCE3 Filed as: LAKESHORE BENEFIT GROUP | 301 ALBANY TURNPIKE CANTON, CT 06019 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | — | $21K | 10.51% |
| LAKESHORE BENEFIT GROUP INSURANCE3 Filed as: LAKESHORE BENEFIT GROUP | 301 ALBANY TURNPIKE CANTON, CT 06019 | SYMETRA LIFE INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES, INC EIN 22-0999690 NONE | Contract Administrator Service code 13 | — | $1.1M |
| I.E. SHAFFER & CO EIN 22-1750854 NONE | Contract Administrator Service code 13 | 830 BEAR TAVERN ROAD PO BOX 1028 WEST TRENTON, NJ 08628 | $747K |
| CAPITAL RX, INC EIN 35-2612946 NONE | Contract Administrator Service code 13 | — | $322K |
| DELTA DENTAL OF NEW JERSEY, INC EIN 22-1896118 NONE | Contract Administrator Service code 13 | — | $73K |
| OBRIEN BELLAND & BUSHINSKY EIN 37-1467056 NONE | Legal Service code 29 | — | $42K |
| EMPOWER ANNUITY INSURANCE CO EIN 06-1050034 NONE | Investment advisory (plan) Service code 27 | — | $40K |
| GERSON & ASSOC CPAS AND ADVISORS PC EIN 22-3163246 NONE | Accounting (including auditing) Service code 10 | 201 WEST PASSAIC STREET SUITE 405 ROCHELLE PARK, NJ 07662 | $27K |
| MILLIMAN LLC NONE | Consulting (general) Service code 16 | 29425 CHARGIN BOULEVARD SUITE 140 PEPPER PIKE, OH 44122 | $21K |
| MSPC CERTIFIED PUBLIC ACCOUNTANTS EIN 22-2951202 NONE | Accounting (including auditing) Service code 10 | — | $14K |
| PRINCETON HEALTHCARE SYSTEM EAP EIN 21-0635009 NONE | Other services Service code 49 | 1000 HERRONTOWN ROAD CLOCK BLDG PRINCETON, NJ 08540 | $12K |
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 | 1,698 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 831 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,529 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW JERSEY, INC | 2,217 | $1.6M |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,646 | $282K |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSRUANCE COMPANY | 1,964 | $474K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,646 | $201K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,217 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.