| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WHITMORE GROUP LTD3 Filed as: THE WHITMORE GROUP, LTD. | 370 OLD COUNTRY ROAD, STE 200 GARDEN CITY, NY 11530 | EMBLEM HEALTH | $30K | $0 | $30K | 3.06% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC | 1065 AVENUE OF THE AMERICAS NEW YORK, NY 10018 | EMBLEM HEALTH | $20K | $0 | $20K | 2.04% |
| ACRISURE LLC3 | 370 OLD COUNTRY ROAD GARDEN CITY, NY 11530 | MUTUAL OF OMAHA | $2K | $292 | $2K | 11.45% |
| ACRISURE LLC3 | 370 OLD COUNTRY ROAD GARDEN CITY, NY 11530 | MUTUAL OF OMAHA | $334 | $26 | $360 | 16.15% |
| ACRISURE LLC3 | 370 OLD COUNTRY ROAD GARDEN CITY, NY 11530 | MUTUAL OF OMAHA | $202 | $22 | $224 | 11.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DANIEL H COOK ASSOCIATES, INC. EIN 11-2424843 THIRD PARTY ADMINISTRATOR | Contract Administrator; Plan Administrator; Direct payment from the plan Service code 13 | 253 WEST 35TH STREET NEW YORK, NY 10001 | $165K |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Contract Administrator; Direct payment from the plan Service code 13 | 450 COLUMBUS BOULEVARD HARTFORD, CT 061150450 | $114K |
| JAMES R GRISI PC EIN 83-2921602 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 199 NO. WELLWOOD AVENUE LINDENHURST, NY 11757 | $93K |
| RHINA MATA EIN 11-2548572 ADMINISTRATOR | Direct payment from the plan; Employee (plan) Service code 30 | 199 N. WELLCOOD AVENUE LINDENHURST, NY 11757 | $59K |
| TIAA, FSB EIN 59-3531592 INVESTMENT MANAGER | Claims processing; Investment management fees paid directly by plan Service code 12 | 211 NORTH BROADWAY ST LOUIS, MO 63102 | $53K |
| WAGNER & ZWERMAN LLP EIN 11-2836481 | Direct payment from the plan; Accounting (including auditing) Service code 10 | 201 OLD COUNTRY RD STE 202 MELVILLE, NY 11747 | $39K |
| SELE-DENT INC. EIN 11-3310187 CLAIMS PROCESSOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | ONE HUNTINGTON QUADRANGLE STE 1S03 MELVILLE, NY 11747 | $29K |
| FEDERATION PENSION BUREAU EIN 13-1787163 THIRD PARTY ADMINISTRATOR | Consulting (general); Direct payment from the plan Service code 16 | 2870 HEMPSTEAD TURNPIKE, SUITE 102 LEVITTOWN, NY 11762 | $20K |
| PROACT INC EIN 16-1571381 CLAIMS PROCESSOR | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | 6333 STATE RTE. 298 EAST SYRACUSE, NY 13057 | $16K |
| SCHULTHEIS & PANATTIERI LLP EIN 13-1577780 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 450 WIRELESS BLVD HAUPPAUGE, NY 11788 | $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 | 801 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 801 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMBLEM HEALTH | 574 | $971K |
| Life insurance | MUTUAL OF OMAHA | 283 | $20K |
| Long-term disability | MUTUAL OF OMAHA | 8 | $2K |
| Prescription drug | EMBLEM HEALTH | 574 | $971K |
| Other(2 contracts) | MUTUAL OF OMAHA | 191 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 574 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.