| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN BLASCH | 71 BEECHWOOD LANE BERKELEY HEIGHTS, NJ 07922 | ANTHEM BLUE CROSS AND BLUE SHIELD (G1921) | $46K | — | $46K | 2.00% |
| DAVID FEINSTEIN3 | 46 BRUNDIGE DRIVE GOLDENS BRIDGE, NY 10526 | ANTHEM BLUE CROSS AND BLUE SHIELD (G1921) | $46K | — | $46K | 2.00% |
| LISA PECONE3 Filed as: LISA S PECONE | 116 REDFERN DR CARY, NC 275188609 | UNITEDHEALTHCARE INSURANCE COMPANY | $76K | — | $76K | 3.75% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 117883914 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $17K | $17K | 0.82% |
| DAVID FEINSTEIN3 Filed as: DAVID S. FEINSTEIN | 46 BRUNDIGE DRIVE GOLDENS BRIDGE, NY 10526 | EMBLEMHEALTH | $67K | — | $67K | 3.85% |
| DAVID FEINSTEIN3 Filed as: DAVID S. FEINSTEIN | 46 BRUNDIGE DRIVE GOLDEN BRIDGE, NY 10526 | EMBLEMHEALTH | $63K | $19K | $82K | 4.99% |
| DAVID FEINSTEIN3 Filed as: DAVID S. FEINSTEIN | 46 BRUNDIGE DRIVE GOLDENS BRIDGE, NY 10526 | EMBLEMHEALTH | $5K | — | $5K | 3.85% |
| DAVID FEINSTEIN3 Filed as: DAVID S. FEINSTEIN | 46 BRUNDIGE DRIVE GOLDENS BRIDGE, NY 10526 | EMBLEMHEALTH | $3K | — | $3K | 4.00% |
| FAGE BENEFITS SOLUTIONS LLC3 | PARKWAY PLAZA II, 30 UNDERCLIFF AVE ELMSFORD, NY 10523 | SOLSTICE HEALTH INSURANCE COMPANY | $427 | — | $427 | 1.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIOSCURI ADMINISTRATOR INC. EIN 11-3408631 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator Service code 13 | PON 604921 BAYSIDE, NY 113604921 | $110K |
| BARNES, IACCARINO & SHEPHERD LLP EIN 26-3858697 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 3 SURREY LANE HEMPSTEAD, NY 11550 | $18K |
| CITRIN COOPERMAN & COMPANY LLP EIN 22-2428965 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 100 JERICHO QUADRANGLE STE 342 JERICHO, NY 11753 | $16K |
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 | 356 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 3 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD (G1921) | 193 | $7.9M |
| Dental | SOLSTICE HEALTH INSURANCE COMPANY | 156 | $43K |
| Vision | SOLSTICE HEALTH INSURANCE COMPANY | 156 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.