| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON PARTNERS NORTHEAST, INC. | 325 SENTRY PARKWAY EAST, SUITE 100 BLUE BELL, PA 19422 | THE UNION LABOR LIFE INSURANCE COMPANY | $64K | $38K | $101K | 13.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON PARTNERS NORTHEAST | 36 S. CHARLES STREET SUITE 100 BALTIMORE, MD 21201 | SYMETRA LIFE INSURANCE COMPANY | $12K | $0 | $12K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $424K |
| BRIDGEWAY BENEFIT TECHNOLOGIES NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 3000 S. LENOLA RD. STE 400 MAPLE SHADE, NJ 08052 | $390K |
| WILLIAM KOLFENBACH EIN 22-6041517 EMPLOYEE | Plan Administrator; Direct payment from the plan Service code 14 | — | $223K |
| MICHAEL ROSENSTOCK EIN 22-6041517 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $158K |
| BEATRIZ VENTURA EIN 22-6041517 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $139K |
| ANDREW ROOS EIN 22-6041517 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $137K |
| REIZA LOPEZ EIN 22-6041517 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $125K |
| ZULMA SANCLEMENTE-CONCHA EIN 22-6041517 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $102K |
| JENNIFER HANIUK EIN 22-6041517 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $100K |
| OLMEC EIN 22-3461295 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $99K |
| BENECARD NONE | Direct payment from the plan; Claims processing Service code 12 | 3131 PRINCETON AVENUE LAWRENCEVILLE, NJ 08648 | $84K |
| ERICA LAFORTE EIN 22-6041517 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $80K |
| TANIA GUERRERO EIN 22-6041517 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| MILENA ROMANICHEN EIN 22-6041517 EMPLOYEE | Direct payment from the plan; Plan Administrator Service code 14 | — | $68K |
| CHRISTINA ROMAN EIN 22-6041517 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $67K |
| DELTA DENTAL OF NJ EIN 22-1896118 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $62K |
| BOLTON PARTNERS NONE | Direct payment from the plan; Actuarial Service code 11 | 100 LIGHT STREET 9TH FLOOR BALTIMORE, MD 21202 | $59K |
| IVETTE ALATORRE EIN 22-6041517 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $57K |
| GIOVANNA RUGGIERO EIN 22-6041517 EMPLOYEE | Plan Administrator; Direct payment from the plan Service code 14 | — | $52K |
| CLEARY, JOSEM & TRIGIANI EIN 23-2657967 NONE | Legal; Direct payment from the plan Service code 29 | — | $49K |
| RICARDO DAVIS EIN 22-6041517 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $48K |
| WEAVER C. BARKSDALE & ASSOCIATES NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 1 BURTON HILLS BLVD. SUITE 100 NASHVILLE, TN 37215 | $46K |
| FISCHER DORWART, P.C. EIN 23-2247478 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $44K |
| PATRIZIA LATORRE EIN 22-6041517 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $41K |
| SUSANIN WIDMAN & BRENNAN, PC NONE | Legal Service code 29 | 1001 OLD CASSATT RD. BERWYN, PA 19312 | $35K |
| EXPRESS SCRIPTS NONE | Claims processing; Direct payment from the plan Service code 12 | 1 EXPRESS WAY ST. LOUIS, MO 63121 | $31K |
| DEVORAH MILNER EIN 22-6041517 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $29K |
| MORGAN STANLEY NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 1585 BROADWAY STREET NEW YORK, NY 10036 | $24K |
| ERNST & YOUNG NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 2005 MARKET STREET PHILADELPHIA, PA 19103 | $17K |
| J.J. PIERSON, P.C. NONE | Legal; Direct payment from the plan Service code 29 | 51 JOHN F. KENNEDY PARKWAY SHORT HILLS, NJ 07078 | $6K |
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 | 1,007 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,035 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 1,007 | $120K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,035 | $748K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,035 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.