| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ERC OF NY, INC.3 Filed as: ERC OF NY | 350 5TH AVENUE NEW YORK, NY 10118 | THE PAUL REVERE LIFE INSURANCE COMPANY | $581 | — | $581 | 5.75% |
| THE WORKSIGHT GROUP LLC3 | 6 ELM STREET MADISON, NJ 07940 | THE PAUL REVERE LIFE INSURANCE COMPANY | $302 | — | $302 | 2.99% |
| BRAD BIEL3 | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | THE PAUL REVERE LIFE INSURANCE COMPANY | $49 | — | $49 | 0.48% |
| C & L REED ASSOCIATES LLC3 Filed as: C&L REED ASSOCIATES LLC | 2911 GLENARDEN DRIVE CHARLESTON, SC 29414 | THE PAUL REVERE LIFE INSURANCE COMPANY | $22 | — | $22 | 0.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DANIEL H. COOK ASSOCIATES, INC. EIN 11-2424843 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | 253 WEST 35TH STREET SUITE 1200 NEW YORK, NY 10001 | $2.7M |
| MAGNACARE ADMINISTRATIVE SERVICES EIN 11-3410766 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | 1600 STEWART AVENUE 7TH FLOOR WESTBURY, NY 11590 | $1.7M |
| AMERICAN HEALTH CARE EIN 68-0146015 CLAIMS PROCESSING | Claims processing; Direct payment from the plan Service code 12 | 3850 ATHERTON ROAD ROCKLIN, CA 95765 | $410K |
| ROBERT M VELLA EIN 11-6490308 PLAN ADMINISTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | 400 GARDEN CITY PLAZA SUITE 106 GARDEN CITY, NY 11530 | $243K |
| EMERSON REID EIN 13-3938007 INSURANCE BROKER | Legal; Direct payment from the plan Service code 29 | 350 FIFTH AVENUE SUITE 3700 NEW YORK, NY 10118 | $211K |
| MERRILL LYNCH WEALTH MANAGEMENT EIN 13-5674085 INVESTMENT CUSTODIAN | Investment management fees paid directly by plan; Custodial (securities) Service code 19 | ONE CROSSROADS DRIVE BLDG ONE BEDMINSTER, NJ 07921 | $190K |
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 CLAIMS PROCESSING | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | 1 HUNTINGTON QUADRANGLE MELVILLE, NY 11747 | $150K |
| RICHARD DOMBROWSKI EIN 11-6490308 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 400 GARDEN CITY PLAZA SUITE 106 GARDEN CITY, NY 11530 | $96K |
| ADELA LUTZ EIN 11-6490308 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 400 GARDEN CITY PLAZA SUITE 106 GARDEN CITY, NY 11530 | $80K |
| FABIAN & BYRN LLC EIN 25-1914887 CLAIMS PROCESSING | Claims processing; Direct payment from the plan Service code 12 | 425 EAGLE ROCK AVENUE ROSELAND, NJ 07068 | $69K |
| SOLSTICE HEALTH INSURANCE COMPANY EIN 14-1917982 ADMINISTRATOR | Legal; Direct payment from the plan Service code 29 | 415 MADISON AVENUE NEW YORK, NY 10017 | $64K |
| BARNES, IACCARINO & SHEPHERD LLP EIN 26-3858697 LEGAL | Legal; Direct payment from the plan Service code 29 | 3 SURREY LANE HEMPSTEAD, NY 11550 | $53K |
| PETER HASHO EIN 11-6490308 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 400 GARDEN CITY PLAZA SUITE 106 GARDEN CITY, NY 11530 | $36K |
| MIRA WILSON EIN 11-6490308 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 400 GARDEN CITY PLAZA SUITE 106 GARDEN CITY, NY 11530 | $30K |
| USA RISK GROUP EIN 03-0288384 CAPTIVE MANAGER | Legal; Direct payment from the plan Service code 29 | 307 FALLS STREET SUITE A GREENVILLE, SC 29601 | $30K |
| ERIKA BURGOS EIN 11-6490308 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 400 GARDEN CITY PLAZA SUITE 106 GARDEN CITY, NY 11530 | $30K |
| JENNIFER JIRA EIN 11-6490308 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 400 GARDEN CITY PLAZA SUITE 106 GARDEN CITY, NY 11530 | $26K |
| WAGNER & ZWERMAN LLP EIN 11-2836481 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | 201 OLD COUNTRY ROAD SUITE 202 MELVILLE, NY 11747 | $25K |
| SUMMIT ACTUARIAL SERVICES EIN 20-3838633 ACTUARIAL | Actuarial; Direct payment from the plan Service code 11 | 115 NORTH CHURCH STREET 3RD FLOOR MOORESTOWN, NJ 08057 | $20K |
| D.D. SERVICES, INC. EIN 11-2705347 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | 1640 HEMPSTEAD TPKE EAST MEADOW, NY 11554 | $6K |
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 | 12,801 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 12,801 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE PAUL REVERE LIFE INSURANCE COMPANY | 32 | $10K |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 11,421 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,421 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.