| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN BLASCH | 71 BEECHWOOD LANE BERKELEY HEIGHTS, NJ 07922 | EMPIRE HEALTHCHOICE ASSURANCE, INC (G1921) | $40K | — | $40K | 1.96% |
| DAVID FEINSTEIN3 Filed as: DAVID S. FEINSTEIN | 46 BRUNDIGE DRIVE GOLDENS BRIDGE, NY 10526 | EMPIRE HEALTHCHOICE ASSURANCE, INC (G1921) | $40K | — | $40K | 1.96% |
| LISA PECONE3 Filed as: LISA S PECONE | 116 REDFERN DR CARY, NC 275188609 | UNITEDHEALTHCARE INSURANCE COMPANY | $71K | — | $71K | 3.75% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 117883914 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $16K | $16K | 0.85% |
| DAVID FEINSTEIN3 Filed as: DAVID S. FEINSTEIN | 46 BRUNDIGE DRIVE GOLDEN BRIDGE, NY 10526 | EMBLEMHEALTH 2 | $75K | — | $75K | 4.16% |
| DAVID FEINSTEIN3 Filed as: DAVID S. FEINSTEIN | 46 BRUNDIGE DRIVE GOLDENS BRIDGE, NY 10526 | EMBLEMHEALTH 1 | $64K | — | $64K | 4.14% |
| DAVID FEINSTEIN3 Filed as: DAVID S. FEINSTEIN | 46 BRUNDIGE DRIVE GOLDENS BRIDGE, NY 10526 | EMBLEMHEALTH 3 | $5K | — | $5K | 4.32% |
| FAGE BENEFITS SOLUTIONS LLC3 | PARKWAY PLAZA II, 30 UNDERCLIFF AVE ELMSFORD, NY 10523 | SOLSTICE HEALTH INSURANCE COMPANY | $4K | — | $4K | 9.96% |
| DAVID FEINSTEIN3 Filed as: DAVID S. FEINSTEIN | 46 BRUNDIGE DRIVE GOLDEN BRIDGE, NY 10526 | EMBLEMHEALTH 4 | $370 | — | $370 | 4.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIOSCURI ADMINISTRATOR INC. EIN 11-3408631 CONTRACT ADMINISTRATOR | Contract Administrator; Direct payment from the plan Service code 13 | 212-07 16TH AVENUE, 2ND FLOOR BAYSIDE, NY 11360 | $109K |
| BARNES, IACCARINO & SHEPHERD LLP EIN 26-3858697 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 3 SURREY LANE HEMPSTEAD, NY 11550 | $18K |
| GETTRY MARCUS CPA PC EIN 13-3418879 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | 88 FROEHLICH BLVD, 3RD FLOOR WOODBURY, NY 11797 | $14K |
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 eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC (G1921) | 195 | $7.5M |
| Dental(4 contracts, 4 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC (G1921) | 195 | $5.5M |
| Vision(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC (G1921) | 195 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.