| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAKESHORE BENEFIT GROUP INSURANCE3 Filed as: LAKESHORE BENEFIT GROUP INS BROKERA | 301 ALBANY TPKE CANTON, CT 060192528 | BERKSHIRE HATHAWAY SPECIALITY INSURANCE COMPANY | $13K | — | $13K | 8.00% |
| LAKESHORE BENEFIT GROUP INSURANCE3 Filed as: LAKESHORE BENEFIT GROUP INS BROKERA | 301 ALBANY TPKE CANTON, CT 060192528 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | — | $9K | 10.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 38-2383171 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $319K |
| ZELIS CLAIMS INTEGRITY LLC EIN 86-1040704 NONE | Other services; Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $292K |
| RAE GROUP LLC EIN 83-4646394 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $61K |
| MORGAN, LEWIS, BOCKIUS, LLP EIN 23-0891050 NONE | Legal; Direct payment from the plan Service code 29 | — | $58K |
| MOONEY,GREEN,SAINDON,MURPHY & WELCH EIN 52-1958229 NONE | Legal; Direct payment from the plan Service code 29 | — | $54K |
| CAREFIRST BLUE CROSS/BLUE SHIELD EIN 52-1385894 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $43K |
| AMERICAN HEALTH HOLDING INC. EIN 31-1368946 NONE | Other services; Direct payment from the plan Service code 49 | — | $33K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $22K |
| CFA, LLC DBA NCAS EIN 52-1187907 NONE | Direct payment from the plan; Other services Service code 49 | — | $15K |
| GALLAGHER FIDUCIARY ADVISORS, LLC EIN 36-4291971 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $14K |
| FIDELIO DENTAL INSURANCE EIN 23-2436056 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $14K |
| UNITED BANK WEALTH MANAGEMENT EIN 58-1447401 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $7K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Investment management fees paid indirectly by plan; Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $2K |
| PACIFIC INCOME ADVISORS, INC. EIN 95-4067974 NONE | Investment management fees paid indirectly by plan; Investment management Service code 28 | — | $0 |
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 | 382 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 122 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 504 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 851 | $90K |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALITY INSURANCE COMPANY | 361 | $167K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 851 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 851 | — |
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.