| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JN SAVASTA CORP3 | 1350 BROADWAY SUITE 410 NEW YORK, NY 10018 | HARTFORD LIFE AND ACCIDENT | $8K | — | $8K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES INC EIN 22-0999690 NONE | Contract Administrator; Direct payment from the plan; Insurance agents and brokers Service code 13 | — | $895K |
| ZELIS CLAIMS INTEGRITY NONE | Other fees; Direct payment from the plan Service code 50 | 2 CROSSROADS DRIVE BEDMINSTER, NJ 07921 | $500K |
| STACEY BRAUN ASSOCIATES INC. EIN 13-2889432 NONE | Investment management fees paid directly by plan; Soft dollars commissions; Investment management Service code 28 | — | $182K |
| SALVATRICE VERILLO EIN 22-6082349 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $128K |
| MICHELE PROCHOV EIN 22-6082349 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $91K |
| CHERYLANN CALISE EIN 22-6082349 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| MSPC CERTIFIED PUBLIC ACCOUNTANTS EIN 22-2951202 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $89K |
| RUTH THORTON EIN 22-6082349 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $80K |
| MICHALINA PACYNA EIN 22-6082349 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $67K |
| DIANE FOLLMER EIN 22-6082349 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $62K |
| SILVANA TURDO EIN 22-6082349 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $61K |
| NICOLE GRABINSKI EIN 22-6082349 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $57K |
| DAWN CARMODY-ITRI EIN 22-6082349 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $56K |
| NICOLE HUERTA EIN 22-6082349 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $56K |
| ANGELA REYES EIN 22-6082349 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| RIFAT FAMDANI EIN 22-6082349 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $54K |
| COHEN WEISS & SIMON LLP EIN 13-1592323 NONE | Legal; Direct payment from the plan Service code 29 | — | $50K |
| CALIBRE CPA GROUP EIN 47-0900880 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $38K |
| JENNIFER MARRETTA EIN 22-6082349 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $31K |
| O'SULLIVAN AND ASSOCIATES EIN 20-8199367 NONE | Actuarial; Direct payment from the plan; Consulting (general) Service code 11 | — | $31K |
| UNITED REVIEW SERVICES EIN 22-2853893 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $27K |
| MARGARITA DEACON EIN 22-6082349 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $21K |
| SCHULTHESIS AND PANNETTIERI EIN 13-1577780 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $21K |
| BANK OF AMERICA EIN 94-1687665 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $19K |
| PETER MCGOURTY EIN 46-4986646 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $14K |
| FITZSIMMONS, KRANTZ & ABRAMS EIN 13-2858927 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $11K |
| DEBRORAH RIONDA EIN 22-6082349 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $9K |
| RAYMOND J FANNER EIN 45-4230673 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $8K |
| LYNCH & MURRAY EIN 22-3352529 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $5K |
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 | 2,027 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,061 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 2,018 | $795K |
| Dental | HORIZON HEALTHCARE SERVICES, INC. | 2,020 | $85K |
| Life insurance(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE COMPANY | 1,495 | $207K |
| Short-term disability | THE UNION LABOR LIFE INSURANCE COMPANY | 589 | $129K |
| Other(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE COMPANY | 1,495 | $207K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,020 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.