| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAKESHORE BENEFIT GROUP INSURANCE3 Filed as: LAKESHORE BENEFIT GROUP INC. | 301 ALBANY TURNPIKE CANTON, CT 06019 | TOKIO MARINE HCC - STOP LOSS GROUP | $52K | — | $52K | 5.50% |
| LAKESHORE BENEFIT GROUP INSURANCE3 Filed as: LAKESHORE BENEFIT GROUP INC. | 529 MAIN STREET, STE 2B NEW HARTFORD, CT 06057 | PRUDENTIAL INSURANCE COMPANY | $3K | — | $3K | 183.40% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY | — | — | $0 | 0.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES, INC EIN 22-0999690 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 2 PENN PLAZA EAST NEWARK, NJ 07105 | $480K |
| I E SHAFFER & CO EIN 22-1750854 NONE | Contract Administrator Service code 13 | PO BOX 1028 WEST TRENTON, NJ 08628 | $321K |
| CAPITAL RX, INC. CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 228 PARK AVENUE SOUTH NEW YORK, NY 10003 | $117K |
| GERSON & ASSOCIATES CPAS AND ADVISO EIN 22-3163246 NONE | Accounting (including auditing) Service code 10 | 201 WEST PASSAIC STREET ROCHELLE PARK, NJ 07662 | $44K |
| PLUMBERS LOCAL UNION NO. 24 PENSION EIN 22-6042823 AFFILIATED | Contract Administrator Service code 13 | 20 FAIRFIELD PLACE WEST CALDWELL, NJ 07006 | $36K |
| WEAVER C BARKSDALE EIN 62-1217255 NONE | Investment management Service code 28 | — | $33K |
| BASIL CASTROVINCI ASSOCIATES EIN 13-2835100 NONE | Consulting (general); Actuarial Service code 11 | 3235 KENNEDY BOULEVARD JERSEY CITY, NJ 07306 | $30K |
| LINDABURY, MCCORMACK & ESTABROOK EIN 22-1943351 NONE | Legal Service code 29 | 53 CARDINAL DRIVE WESTFIELD, NJ 07091 | $26K |
| ORANSKY, SCARAGGI, & BORG, P.C. EIN 22-3522685 NONE | Legal Service code 29 | 175 FAIRFIELD AVENUE WEST CALDWELL, NJ 07007 | $24K |
| ENVISION PHARMACEUTICAL SERVICES IN EIN 05-0570786 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $14K |
| ZAZZALI, FAGELLA, NOWAK KLEINBAUM, EIN 22-1973215 NONE | Legal Service code 29 | — | $10K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Investment management Service code 28 | 275 SEVENTH AVENUE NEW YORK, NY 10001 | $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 | 586 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 450 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,036 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 1,036 | $0 |
| Life insurance | PRUDENTIAL INSURANCE COMPANY | 592 | $18K |
| Stop-loss / reinsurancereinsurance | HORIZON HEALTHCARE SERVICES, INC. | 1,036 | $71K |
| Other(2 contracts, 2 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 1,036 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,036 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.