| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | $6K | — | $6K | 5.11% |
| RJ DAVIS ASSOCIATES3 | 1040 BROAD STREET SHREWSBURY, NJ 07702 | USABLE LIFE | $6K | — | $6K | 4.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $1.1M |
| UFCW LOCAL 1262 PENSION FUND EIN 22-6074414 AFFILIATED BENEFIT FUND | Direct payment from the plan; Plan Administrator Service code 14 | — | $785K |
| UFCW LOCAL 1262 EIN 22-1339607 AFFILIATED LABOR ORG | Direct payment from the plan; Plan Administrator Service code 14 | — | $204K |
| FRANK VACARRO & ASSOCIATES, INC. EIN 23-2148108 NONE | Contract Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $152K |
| MORGAN, LEWIS & BOCKIUS LLP EIN 23-0891050 NONE | Legal; Direct payment from the plan Service code 29 | — | $103K |
| HORIZON HEALTHCARE DENTAL SERVICES EIN 22-3267136 NONE | Claims processing; Plan Administrator; Direct payment from the plan Service code 12 | — | $102K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Claims processing; Plan Administrator; Direct payment from the plan Service code 12 | — | $84K |
| MURPHY ANDERSON PLLC EIN 26-3092374 NONE | Legal; Direct payment from the plan Service code 29 | — | $78K |
| SEGAL CONSULTING EIN 13-1835864 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $60K |
| NOVAK FRANCELLA LLP EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $48K |
| BEACON HEALTH OPTIONS EIN 54-1414194 NONE | Claims processing; Direct payment from the plan; Plan Administrator Service code 12 | — | $46K |
| CHARTWELL INVESTMENT PARTNERS EIN 36-4776242 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $16K |
| SEGALL, BRYANT & HAMILL EIN 41-1788385 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $15K |
| WELL FARGO BANK N.A. EIN 94-1347393 NONE | Direct payment from the plan; Other services Service code 49 | — | $10K |
| INVESTMENT PERFORMANCE SERVICES LLC EIN 58-2432390 NONE | Investment management fees paid directly by plan; Investment advisory (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 | 4,166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 91 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,257 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HORIZON INSURANCE COMPANY | 4,055 | $175K |
| Life insurance | USABLE LIFE | 4,622 | $121K |
| Stop-loss / reinsurancereinsurance | HORIZON HEALTHCARE SERVICES, INC. | 2,278 | $1.7M |
| Other(2 contracts, 2 carriers) | ARAG INSURANCE COMPANY | 19,707 | $921K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 19,707 | — |
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.