| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JN SAVASTA CORP3 Filed as: SAVASTA J N CORP | 1350 BROADWAY RM 410 NEW YORK, NY 100180973 | COMPANION LIFE INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| JN SAVASTA CORP3 Filed as: SAVASTA J N CORP | 1350 BROADWAY RM 410 NEW YORK, NY 100180973 | MUTUAL OF OMAHA INSURANCE COMPANY | $888 | — | $888 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE BLUE CROSS AND BLUE SHIELD EIN 23-7391136 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $214K |
| EMPLOYEES EIN 23-7218454 EMPLOYEES | Employee (plan); Direct payment from the plan Service code 30 | — | $169K |
| SAVASTA AND COMPANY, INC EIN 13-3879959 NONE | Direct payment from the plan; Contract Administrator; Actuarial; Consulting (general) Service code 11 | — | $103K |
| WITHUMSMITH BROWN, PC EIN 22-2027092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $77K |
| COHEN, WEISS & SIMON, LLP EIN 13-1592323 NONE | Legal; Direct payment from the plan Service code 29 | — | $76K |
| INNOVATIVE SOFTWARE SOLUTIONS EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Direct payment from the plan Service code 15 | — | $34K |
| MED-REVIEW, INC. EIN 13-3240352 NONE | Direct payment from the plan; Other services Service code 49 | — | $21K |
| HEALTHPLEX, INC EIN 11-2714365 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $14K |
| PAUL DEMASI EIN 23-7218454 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $6K |
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 | 672 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 695 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 706 | $75K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 706 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 706 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.