| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BODNER BENEFITS GROUP INC | 4 CYR CT NEW CITY, NY 10956 | EMPIRE HEALTH CHOICE | $2K | — | $2K | 1.03% |
| ANDREW FRANZE | 951 E 241ST ST BRONX, NY 10466 | EMPIRE HEALTH CHOICE | $2K | — | $2K | 0.69% |
| GREATER METRO AGENCY INC | 2003 JERICHO TURNPIKE NEW HYDE PARK, NY 11040 | EMPIRE HEALTH CHOICE | $209 | — | $209 | 0.10% |
| BODNER BENEFITS GROUP INC Filed as: BODNER BENEFITS GROUP | 4 CYR CT NEW CITY, NY 10956 | DENTCARE | $4K | — | $4K | 9.78% |
| ANDREW FRANZE | 950 EAST 241ST ST BRONX, NY 10466 | EMPIRE HEALTH CHOICE HMO, INC. | $552 | — | $552 | 2.84% |
| FNA INSURANCE SERVICES INC | C/O HUB INTERNATIONAL 10 SUNNYSIDE BLVD WOODBURY, NY 11797 | GUARDIAN | $1K | $384 | $2K | 14.99% |
| ADAM KAUFMAN Filed as: ADAM S KAUFMAN | 4 HEIDI LANE MOUNT SINAI, NY 11766 | GUARDIAN | $9 | — | $9 | 0.07% |
| ANDREW FRANZE | 951 EAST 241 STREET BRONX, NY 10466 | EMPIRE HEALTH CHOICE HMO, INC. | $24 | — | $24 | 1.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MICHAEL PAGAN EIN 11-2691482 NONE | Employee (plan) Service code 30 | — | $216K |
| ERBA CONSULTING GROUP EIN 27-0977556 NONE | Consulting (general) Service code 16 | — | $72K |
| ROBERT SUHR EIN 11-2691482 NONE | Other fees Service code 99 | — | $32K |
| NICOLE CASSON EIN 11-2691482 NONE | Employee (plan) Service code 30 | — | $25K |
| BRADY MCGUIRE & STEINBERG PC EIN 11-2691482 NONE | Legal Service code 29 | — | $25K |
| CASTIGLIA LLP EIN 46-2725636 NONE | Accounting (including auditing) Service code 10 | — | $12K |
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 | 570 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 570 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | EMPIRE HEALTH CHOICE | 275 | $239K |
| Dental(5 contracts, 4 carriers) | DENTCARE | 84 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.