| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | — | $16K | $16K | 3.68% |
| DAVIS RICHARDS, C/O RJ DAVIS ASSOCI3 | 1040 BROAD ST SHREWSBURY, NJ 07702 | USABLE LIFE | $12K | — | $12K | 2.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $2.7M |
| UFCW LOCAL 1262 PENSION FUND EIN 23-6074414 AFFILIATED BENEFIT FUND | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $1.3M |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $406K |
| UFCW LOCAL 1262 EIN 22-1339607 AFFILIATED ORGANIZATION | Consulting (general); Direct payment from the plan; Other services Service code 16 | — | $299K |
| HORIZON HEALTHCARE DENTAL SERVICES EIN 22-3267136 NONE | Direct payment from the plan; Plan Administrator; Claims processing Service code 12 | — | $292K |
| FRANK VACCARO & ASSOCIATES, INC. EIN 23-2148108 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | — | $270K |
| BUCK CONSULTANTS LLC EIN 13-3954297 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $73K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $50K |
| CARELON BEHAVIORAL HEALTH, INC. EIN 54-1414194 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $47K |
| SLEVIN & HART, P.C. EIN 52-1708613 NONE | Legal; Direct payment from the plan Service code 29 | — | $43K |
| OCEAN COMPUTER GROUP EIN 22-2595133 NONE | Other services; Direct payment from the plan Service code 49 | — | $12K |
| WINSTON SUPPORT SERVICES, LLC EIN 80-0004314 NONE | Other services; Direct payment from the plan Service code 49 | — | $10K |
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 | 11,633 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 66 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 11,699 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HORIZON INSURANCE COMPANY | 12,782 | $487K |
| Life insurance | USABLE LIFE | 14,107 | $446K |
| Stop-loss / reinsurancereinsurance | HORIZON HEALTHCARE SERVICES | 5,462 | $6.7M |
| Other(2 contracts, 2 carriers) | ARAG INSURANCE COMPANY | 14,164 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 14,164 | — |
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.