| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAKESHORE BENEFIT GROUP INSURANCE3 | 301 ALBANY TURNPIKE CANTON, CT 06019 | AMALGAMATED LIFE INSURANCE COMPANY | — | $9K | $9K | 10.00% |
| LAKESHORE BENEFIT GROUP INSURANCE3 | 301 ALBANY TURNPIKE CANTON, CT 06019 | SYMETRA LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS/CAREMARK EIN 75-2882129 PHARMACY BENEFIT MGMT | Claims processing Service code 12 | — | $2.2M |
| CIGNA HEALTH & LIFE INSURANCE COMPA EIN 59-1031071 NONE | Non-monetary compensation; Claims processing; Other services; Float revenue; Named fiduciary; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $317K |
| BENESYS, INC. EIN 38-2383171 NONE | Contract Administrator Service code 13 | — | $224K |
| MOONEY, GREEN SAINDON, MURPHY & WEL EIN 52-1958229 NONE | Legal Service code 29 | — | $33K |
| LONGFELLOW INVESTMENT MANAGEMENT CO EIN 04-2933956 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $24K |
| WEYRICH CRONIN & SORRA, LLC EIN 81-4643077 NONE | Accounting (including auditing) Service code 10 | — | $21K |
| PNC INSTITUTIONAL INVESTMENTS EIN 25-1211909 NONE | Product termination fees (surrender charges, etc.); Custodial (securities); Distribution (12b-1) fees; Shareholder servicing fees; Investment advisory (plan); Legal Service code 19 | — | $18K |
| BOLTON PARTNERS, INC. EIN 52-1231144 NONE | Actuarial Service code 11 | — | $17K |
| TATC CONSULTING NONE | Consulting (general); Direct payment from the plan Service code 16 | 8251 GREENSBORO DRIVE MCLEAN, VA 22102 | $17K |
| PNC BANK NONE | Other investment fees and expenses Service code 72 | ONE FINANCIAL PARKWAY KALAMAZOO, MI 49009 | $10K |
| DAHAB ASSOCIATES EIN 11-2783874 NONE | Consulting (pension) Service code 17 | — | $8K |
| DOYLE PRINTING INC EIN 53-0191325 NONE | Copying and duplicating; Other services Service code 36 | 5206 46TH AVENUE HYATTSVILLE, MD 20781 | $8K |
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 | 499 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 142 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 641 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 659 | $59K |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 551 | $93K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 659 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 659 | — |
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.