| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAKESHORE BENEFIT GROUP INSURANCE | 301 ALBANY TURNPIKE CANTON, CT 06019 | HORIZON HEALTHCARE SERVICES, INC. | $28K | — | $28K | 3.71% |
| HORIZON INSURANCE COMPANY | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | — | $6K | $6K | 9.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON EIN 22-0999690 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $368K |
| I.E. SHAFFER EIN 22-1750854 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $253K |
| UBS NONE | Investment management fees paid directly by plan; Investment advisory (plan); Investment management Service code 27 | 1285 AVE OF THE AMERICAS NEW YORK, NY 10019 | $220K |
| BARATZ & ASSOCIATES, P.A. NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 4B EVES DR MARLTON, NJ 08053 | $41K |
| PAUL A. MONTALBANO, ESQ, LLC EIN 04-3669184 NONE | Legal; Direct payment from the plan Service code 29 | — | $26K |
| RAE GROUP EIN 83-4646394 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $3K |
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 | 851 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 851 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HORIZON INSURANCE COMPANY | 843 | $80K |
| Life insurance | USABLE LIFE | 810 | $60K |
| Stop-loss / reinsurancereinsurance | HORIZON HEALTHCARE SERVICES, INC. | 846 | $742K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 846 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.