No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JOINT INDUSTRY BOARD EIN 13-0891035 PLAN ADMINISTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $149K |
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Other services; Contract Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $67K |
| MILLIMAN EIN 91-0675641 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $12K |
| DD SERVICES INC. EIN 11-2705347 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $10K |
| DEUTSCH BANK EIN 13-6065488 NONE | Custodial (other than securities); Direct payment from the plan Service code 18 | — | $8K |
| STATE STREET BANK & TRUST COMPANY EIN 04-1867445 NONE | Investment management; Other fees; Direct payment from the plan Service code 28 | — | $426 |
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 | 1,667 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 457 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 65 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 65 | — |
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.