| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | — | $14K | $14K | 3.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $3.0M |
| 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 |
| FRANK VACCARO & ASSOCIATES, INC. EIN 23-2148108 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator Service code 13 | — | $240K |
| UFCW LOCAL 1262 EIN 22-1339607 AFFILIATED ORGANIZATION | Direct payment from the plan; Consulting (general) Service code 16 | — | $238K |
| HORIZON HEALTHCARE DENTAL SERVICES EIN 22-3267136 NONE | Claims processing; Plan Administrator; Direct payment from the plan Service code 12 | — | $237K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $228K |
| BEACON HEALTH OPTIONS EIN 54-1414194 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $118K |
| PDI, INC. NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $113K |
| BUCK CONSULTANTS LLC EIN 13-3954297 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $101K |
| SLEVIN & HART, P.C. EIN 52-1708613 NONE | Legal; Direct payment from the plan Service code 29 | — | $87K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $50K |
| RJ DAVIS ASSOCIATES NONE | Consulting (general); Direct payment from the plan; Consulting fees Service code 16 | 1040 BROAD STREET SHREWSBURY, NJ 07702 | $13K |
| PSG CONSULTING, LLC NONE | Consulting (general); Direct payment from the plan Service code 16 | 14881 QUORUM DR., STE 850 DALLAS, TX 752547069 | $8K |
| INVESTMENT PERFORMANCE SERVICES LLC EIN 58-2432390 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $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 | 10,412 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 115 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 10,527 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HORIZON INSURANCE COMPANY | 12,783 | $536K |
| Life insurance | USABLE LIFE | 12,953 | $349K |
| Stop-loss / reinsurancereinsurance | HORIZON HEALTHCARE SERVICES | 6,063 | $6.7M |
| Other(2 contracts, 2 carriers) | ARAG INSURANCE COMPANY | 13,073 | $885K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,073 | — |
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.