| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VINCENT SOMBROTTO | 4 COVE LANE PORT WASHINGTON, NY 11050 | OXFORD HEALTH INSURANCE INC | $136K | — | $136K | 3.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROSEMARY MCCARTHY EIN 13-1835737 EMPLOYEE | Contract Administrator Service code 13 | 901 NORTH BROADWAY N. WHITE PLAINS, NY 10603 | $51K |
| LAYNE MCCARTHY EIN 13-1835737 EMPLOYEE | Contract Administrator Service code 13 | 901 NORTH BROADWAY N. WHITE PLAINS, NY 10603 | $51K |
| CHRISTINE LAURIE EMPEY EIN 13-1835737 EMPLOYEE | Contract Administrator Service code 13 | 901 NORTH BROADWAY N. WHITE PLAINS, NY 10603 | $48K |
| BRYAN MCCARTHY ESQ. EIN 01-0727299 LAWYER | Insurance agents and brokers Service code 22 | 271 NORTH AVE NEW ROCHELLE, NY 10801 | $46K |
| IBEW LOCAL 1430 EIN 13-1589405 UNION SPONSOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 14 | 901 NORTH BROADWAY N. WHITE PLAINS, NY 10603 | $36K |
| SAMUEL GONZALEZ EIN 13-1835737 EMPLOYEE | Employee (plan) Service code 30 | 901 NORTH BROADWAY N. WHITE PLAINS, NY 10603 | $26K |
| LAWRENCE S. FISCHER, CPA EIN 52-2326815 ACCOUNTANT | Accounting (including auditing) Service code 10 | 92 DOSORIS LANE GLEN COVE, NY 11542 | $23K |
| JOHN TIERNEY EIN 13-1835737 EMPLOYEE | Contract Administrator Service code 13 | 901 NORTH BROADWAY N. WHITE PLAINS, NY 10603 | $14K |
| SANCARELLI & JACOBSON EIN 13-3053796 LAWYER | Insurance agents and brokers Service code 22 | 22 FIRST STREET MT. VERNON, NY 10550 | $13K |
| SUMMIT ACTUARIAL SERVICES EIN 20-3838633 ACTUARY | Actuarial Service code 11 | 123 PREAKNESS DRIVE MT. LAUREL, NJ 08054 | $9K |
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 | 205 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 198 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 435 | — |
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.