| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VINCENT SOMBROTTO | 4 COVE LANE PORT WASHINGTON, NY 11050 | EMBLEM HEALTH | $94K | — | $94K | 2.91% |
| CLOUD PEAK LLC | — | EMBLEM HEALTH | — | $60K | $60K | 1.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROSEMARIE MCCARTHY EIN 13-1835737 EMPLOYEE | Contract Administrator Service code 13 | 84 BUSINESS PARK DR ARMONK, NY 10504 | $79K |
| LAYNE MCCARTHY EIN 13-1835737 EMPLOYEE | Contract Administrator Service code 13 | 84 BUSINESS PARK DR ARMONK, NY 10504 | $57K |
| CHRISTINE LAURIE EMPEY EIN 13-1835737 EMPLOYEE | Contract Administrator Service code 13 | 84 BUSINESS PARK DR ARMONK, NY 10504 | $54K |
| IBEW LOCAL 1430 EIN 13-1589405 UNION SPONSOR | Plan Administrator Service code 14 | 84 BUSINESS PARK DR ARMONK, NY 10504 | $46K |
| MCCARTHY & PREECE PLLC EIN 84-3667887 LAWYER | Insurance agents and brokers Service code 22 | 118 N. BEDFORD RD MT KISCO, NY 10549 | $42K |
| JOHANA WEBER EIN 13-1835737 EMPLOYEE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 84 BUSINESS PARK DR ARMONK, NY 10504 | $26K |
| ANDREW FAIR ESQ EIN 20-3322400 TRUSTEE | Trustee (individual) Service code 20 | 19 INTERLAKEN DR EASTCHESTER, NY 10709 | $18K |
| SUMMIT ACTUARIAL SERVICES EIN 20-3838633 ACTUARY | Actuarial Service code 11 | 123 PREAKNESS DRIVE MT. LAUREL, NJ 08054 | $7K |
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 | 273 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.