| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WHITMORE GROUP LTD3 Filed as: THE WHITMORE GROUP LTD. | 370 OLD COUNTRY RD GARDEN CITY, NY 11530 | EMBLEM HEALTH | $60K | — | $60K | 2.25% |
| HEFFERMAN INSURANCE BROKERS3 | 1350 CARLBACK AVE. - STE 100 WALNUT CREEK, CA 945967231 | EMBLEM HEALTH | $34K | — | $34K | 1.27% |
| HEFFERMAN INSURANCE BROKERS3 | 1350 CARLBACK AVE. - STE 100 WALNUT CREEK, CA 945967231 | COMPANION LIFE INSURANCE COMPANY | $680 | $502 | $1K | 8.30% |
| WHITMORE GROUP LTD3 Filed as: THE WHITMORE GROUP LTD. | 370 OLD COUNTRY RD GARDEN CITY, NY 11530 | COMPANION LIFE INSURANCE COMPANY | $744 | — | $744 | 5.22% |
| HEFFERMAN INSURANCE BROKERS3 | 1350 CARLBACK AVE. - STE 100 WALNUT CREEK, CA 945967231 | MUTUAL OF OMAHA INSURANCE COMPANY | $421 | — | $421 | 14.99% |
| HEFFERMAN INSURANCE BROKERS3 | 1350 CARLBACK AVE. - STE 100 WALNUT CREEK, CA 945967231 | MUTUAL OF OMAHA INSURANCE COMPANY | $45 | $34 | $79 | 8.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PROMINIS MEDICAL SERVICES PC EIN 20-1410754 NONE | Direct payment from the plan; Other services Service code 49 | — | $72K |
| EILEEN KWIATKOWSKI EIN 11-2548572 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $67K |
| JOSEPH SCIASCIA EIN 11-2548572 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| JAMES R GRISI, PC EIN 47-4672103 NONE | Legal; Direct payment from the plan Service code 29 | — | $31K |
| NOVAK FRANCELLA,LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $30K |
| SELE-DENT INC. EIN 11-3310187 NONE | Direct payment from the plan Service code 50 | — | $21K |
| FEDERATION PENSION BUREAU INC EIN 13-1787163 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $18K |
| ARCHER BYINGTON GLENNON & LEVINE LL EIN 26-0873462 NONE | Legal; Direct payment from the plan Service code 29 | — | $17K |
| TECH HELP GROUP NONE | Direct payment from the plan; Other services Service code 49 | 11 POWER HOUSE ROAD ROSLYN HEIGHT, NY 11577 | $9K |
| ARIA EMPLOYEE BENEFIT SERVICES, INC NONE | Direct payment from the plan; Other services Service code 49 | 371 MERRICK RD, SUITE 403 ROCKVILLE CENTRE, NY 11570 | $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 | 938 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 938 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMBLEM HEALTH | 291 | $2.7M |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 303 | $14K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 12 | $3K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 302 | $946 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.