| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAKESHORE BENEFIT GROUP INSURANCE3 | 301 ALBANY TURNPIKE CANTON, CT 06019 | AMALGAMATED LIFE INSURANCE COMPANY | $10K | — | $10K | 10.00% |
| LAKESHORE BENEFIT GROUP INSURANCE3 | 301 ALBANY TURNPIKE CANTON, CT 06019 | SYMETRA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| EDWARD JCHICOSKI3 | PO BOX 670 NEW HARTFORD, CT 06057 | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | $1K | $0 | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS/CAREMARK EIN 75-2882129 PHARMACY BENEFIT MGMT | Claims processing Service code 12 | — | $1.9M |
| CIGNA HEALTH & LIFE INSURANCE COMPA EIN 59-1031071 NONE | Named fiduciary; Other services; Claims processing; Direct payment from the plan; Non-monetary compensation; Participant communication; Float revenue; Contract Administrator Service code 12 | — | $365K |
| CARDAY ASSOCIATES EIN 53-0257019 NONE | Contract Administrator Service code 13 | — | $223K |
| MOONEY, GREEN SAINDON, MURPHY & WEL EIN 52-1958229 NONE | Legal Service code 29 | — | $61K |
| LONGFELLOW INVESTMENT MANAGEMENT CO EIN 04-2933956 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $23K |
| PNC INSTITUTIONAL INVESTMENTS EIN 25-1211909 NONE | Distribution (12b-1) fees; Legal; Shareholder servicing fees; Product termination fees (surrender charges, etc.); Custodial (securities); Investment advisory (plan) Service code 19 | — | $23K |
| BOLTON PARTNERS, INC. EIN 52-1231144 NONE | Actuarial Service code 11 | — | $20K |
| WEYRICH CRONIN & SORRA, LLC EIN 81-4643077 NONE | Accounting (including auditing) Service code 10 | 1301 YORK ROAD LUTHERVILLE, MD 21093 | $18K |
| DAHAB ASSOCIATES EIN 11-2783874 NONE | Consulting (pension) Service code 17 | — | $10K |
| PNC BANK NONE | Other investment fees and expenses Service code 72 | ONE FINANCIAL PARKWAY KALAMAZOO, MI 49009 | $10K |
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 | 798 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 136 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 934 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 1,030 | $59K |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 909 | $99K |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 1,030 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,030 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.