| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAKESHORE BENEFIT GROUP INSURANCE3 | P.O. BOX 670, 529 MAIN ST, SUITE 2B NEW HARTFORD, CT 060574122 | AMALGAMATED LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| LAKESHORE BENEFIT GROUP INSURANCE3 | P.O. BOX 670, 529 MAIN ST, SUITE 2B NEW HARTFORD, CT 060574122 | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | $4K | — | $4K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CARDAY ASSOCIATES EIN 53-0257019 NONE | Contract Administrator Service code 13 | — | $224K |
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 NONE | Non-monetary compensation; Direct payment from the plan; Contract Administrator; Other services; Participant communication; Named fiduciary; Claims processing; Float revenue Service code 12 | — | $209K |
| MOONEY, GREEN, SAINDON, MURPHY & WE EIN 52-1958229 NONE | Legal Service code 29 | — | $55K |
| LONGFELLOW INVESTMENT MANAGER EIN 04-2933956 NONE | Investment management Service code 28 | — | $18K |
| DANIEL A. WINTERS & COMPANY, CPA EIN 23-2586736 NONE | Accounting (including auditing) Service code 10 | — | $16K |
| PNC INSTITUTIONAL INVESTMENT EIN 25-1211909 NONE | Investment advisory (plan); Shareholder servicing fees; Custodial (securities); Distribution (12b-1) fees Service code 19 | — | $15K |
| BOLTON PARTNERS, INC. EIN 52-1231144 NONE | Actuarial Service code 11 | — | $13K |
| DAHAB ASSOCIATES, INC. EIN 11-2783874 NONE | Consulting (pension) Service code 17 | — | $7K |
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 | 373 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 129 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 502 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | 555 | $44K |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 445 | $66K |
| Other | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | 555 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 555 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.