| 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 INSURANCE COMPANY | $48K | — | $48K | 7.00% |
| LAKESHORE BENEFIT GROUP INSURANCE3 Filed as: LAKESHORE BENEFIT GROUP | 301 ALBANY TURNPIKE CANTON, CT 06019 | AMALGAMATED LIFE INSURANCE COMPANY | $6K | — | $6K | 16.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LABOR FIRST LLC EIN 06-1750191 NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | 1000 MIDLANTIC DRIVE, SUITE 100 MOUNT LAUREL, NJ 08054 | $958K |
| I.E. SHAFFER & CO. EIN 22-1750854 NONE | Contract Administrator; Direct payment from the plan Service code 13 | 830 BEAR TAVERN ROAD, PO BOX 1028 WEST TRENTON, NJ 08628 | $396K |
| AETNA LIFE INSURANCE CO EIN 06-6033492 NONE | Direct payment from the plan; Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06103 | $363K |
| CAPITAL RX, INC. NONE | Other services; Direct payment from the plan Service code 49 | 228 PARK AVENUE SOUTH, SUITE 87234 NEW YORK, NY 10003 | $198K |
| DELTA DENTAL OF NJ EIN 22-1896118 NONE | Other services; Direct payment from the plan Service code 49 | 1639 NJ ROUTE 10 PARSIPPANY, NJ 07054 | $59K |
| MSPC CERTIFIED PUBLIC ACCOUNTANTS EIN 22-2951202 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 340 NORTH AVENUE EAST CRANFORD, NJ 07016 | $51K |
| PELLETTIERI, RABSTEIN & ALTMAN EIN 22-2353673 NONE | Legal; Direct payment from the plan Service code 29 | 989 LENOX DRIVE, 101 LAWRENCE TOWNSHIP, NJ 08648 | $33K |
| PRINCETON HEALTHCARE SYSTEM EAP EIN 21-0635009 NONE | Other services; Direct payment from the plan Service code 49 | 1000 HERRONTOWN ROAD, CLOCK BLDG PRINCETON, NJ 08540 | $33K |
| VANGUARD INSTITUTIONAL INVESTOR SER EIN 13-1423090 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | P.O. BOX 7800 PHILADELPHIA, PA 19101 | $17K |
| MILLIMAN INC. EIN 91-0675641 NONE | Direct payment from the plan; Consulting (general) Service code 16 | 29425 CHAGRIN BLVD, SUITE 140 PEPPER PIKE, OH 44122 | $11K |
| PFM ASSET MANAGEMENT, LLC EIN 23-3087064 NONE | Custodial (securities); Investment management fees paid directly by plan Service code 19 | TWO LOGAN SQUARE, SUITE 1600 PHILADELPHIA, PA 19103 | $10K |
| THE MCKEOGH COMPANY NONE | Direct payment from the plan; Actuarial Service code 11 | 200 BARR HARBOR DRIVE, SUITE 225 WEST CONSHOHOCKEN, PA 19428 | $9K |
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 | 375 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NJ, INC | 1,079 | $1.0M |
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 804 | $39K |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 966 | $686K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,079 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.