| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| H BAS SOLUTIONS LLC3 | 108 S FRANKLIN AVE STE 5B VALLEY STREAM, NY 11580 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 1.09% |
| GUTMANS INSURANCE BROKERAGE INC3 Filed as: GUTMANS INS BROKERAGE INC | 1066 E 2ND ST BROOKLYN, NY 11230 | SUN LIFE ASSURANCE COMPANY OF CANADA | $31K | $12K | $43K | 12.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERICAN PLAN ADMINISTRATORS LLC THIRD PARTY ADMINISTRATOR | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 18 HEYWARD ST BROOKLYN, NY 11249 | $131K |
| H BAS SOLUTIONS LLC INSURANCE BROKER | Insurance agents and brokers Service code 22 | 108 S FRANKLIN AVE STE 5B VALLEY STREAM, NY 11580 | $43K |
| SMITHRX PRESCRIPTION DRUG VENDOR | Other services Service code 49 | 300 BRANNAN ST SUITE 601 SAN FRANCISCO, CA 94107 | $29K |
| FASTEN HALBERSTAM LLP EIN 47-2319109 PLAN AUDITOR | Accounting (including auditing) Service code 10 | 40 WALL STREET SUITE 3602 NEW YORK, NY 10005 | $20K |
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 | 399 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 400 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 439 | $933K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 439 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.