No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 CLAIMS PROCESSOR | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | 3350 PEACHTREE ROAD POB 30302-445 ATLANTA, GA 303261039 | $933K |
| EXPRESS-SCRIPTS INC EIN 43-1420563 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | ONE EXPRESS WAY ST. LOUIS, MO 63121 | $73K |
| DELTA DENTAL OF NEW YORK, INC. EIN 11-1980218 CLAIMS PROCESSOR | Claims processing; Contract Administrator Service code 12 | ONE DELTA DRIVE MECHANICSBURG, PA 17055 | $58K |
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 | 1,820 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 568 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,388 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMBLEM HEALTH - POS | 8 | $186K |
| Vision | EYEMED VISION CARE | 3,271 | $67K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK | 3,955 | $393K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,544 | $430K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK | 3,217 | $158K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,955 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.