| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY | 333 WEST 34TH STREET NEW YORK, NY 10001 | EMPIRE HEALTHCHOICE ASSURANCE INC | $30K | — | $30K | 1.66% |
| JOHN H BLASCH3 Filed as: JOHN H. BLASCH | 71 BEECHWOOD LN. BERKELEY HEIGHTS, NJ 07922 | FIRST SYMETRA NATIONAL LIFE INSURANCE CO. OF NEW YORK | $33K | $4K | $37K | 13.25% |
| JOHN H BLASCH3 Filed as: JOHN H. BLASCH | 71 BEECHWOOD LN. BERKELEY HEIGHTS, NJ 07922 | FIRST SYMETRA NATIONAL LIFE INSURANCE CO. OF NEW YORK | $7K | $2K | $9K | 9.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 NONE | Claims processing; Other fees; Float revenue; Direct payment from the plan Service code 12 | — | $8.0M |
| EMPIRE HEALTHCHOICE ASSURANCE INC EIN 23-7391136 NONE | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | — | $1.7M |
| METROPOLITAN MANAGEMENT SERVICES EIN 45-3845437 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | — | $577K |
| DONNA OWENS EIN 13-2873303 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $173K |
| MARSHALL & MOSS PAYROLL COMPLIANCE EIN 04-3652965 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $148K |
| CIGNA EIN 06-1059331 NONE | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Float revenue; Participant communication Service code 12 | — | $141K |
| MICHAEL SPILLANE EIN 13-2873303 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $132K |
| DAVIS VISION INC EIN 11-3051991 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $130K |
| THE SEGAL COMPANY EIN 06-0839113 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $82K |
| STARFIRE PRINTING NONE | Direct payment from the plan; Other fees Service code 50 | 751 COATES AVE N 31 HOLBROOK, NY 11741 | $63K |
| BRIGID WEINGARTNER EIN 13-2873303 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| BARNES,IACCARINO & SHEPHERD, LLC EIN 43-1995226 NONE | Legal; Direct payment from the plan Service code 29 | — | $53K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $52K |
| HEALTHPLEX EIN 11-2714365 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $52K |
| VISION SCREENING INC. EIN 11-2358021 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $44K |
| GENERAL VISION SERVICES, LLC EIN 11-3580576 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $43K |
| MARSHALL & MOSS, LLP EIN 11-3360166 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $40K |
| WHITESTAR ADVISORS LLC EIN 03-0496641 NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | — | $39K |
| COMPREHENSIVE PROFESSIONAL SYS. INC EIN 13-3025997 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $31K |
| SEGAL MARCO ADVISORS INC EIN 13-2646110 NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | — | $30K |
| HEALTH PLAN SYSTEMS INC. NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 2025 LINCOLN HIGHWAY, STATE RTE 27 EDISON, NJ 08817 | $25K |
| NORTH SHORE UNIVERSITY HOSPITAL EIN 11-1562701 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $22K |
| MARTIN ROSS NONE | Consulting (general); Direct payment from the plan Service code 16 | 72 STRATFORD COURT FARMINGDALE, NY 11735 | $14K |
| INNER IMAGING, PC NONE | Direct payment from the plan; Claims processing Service code 12 | 307 E. 63RD STREET NEW YORK, NY 10065 | $13K |
| ARAMARK SPORTS & ENTERTAINMENT SERV EIN 95-2051630 NONE | Direct payment from the plan; Other fees Service code 50 | — | $12K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Custodial (securities); Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 19 | — | $11K |
| THE DIET DOC OF LONG ISLAND, INC. NONE | Direct payment from the plan; Other fees Service code 50 | 11 STEWART AVE. HUNTINGTON, NY 11743 | $9K |
| DDS, INC. EIN 11-2705347 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $8K |
| ROGER E. MAHER NONE | Legal; Direct payment from the plan Service code 29 | 23 83RD STREET BROOKLYN, NY 11209 | $5K |
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 | 2,521 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 136 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,657 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 2 carriers) | FIRST SYMETRA NATIONAL LIFE INSURANCE CO. OF NEW YORK | 2,527 | $548K |
| Short-term disability(3 contracts, 2 carriers) | FIRST SYMETRA NATIONAL LIFE INSURANCE CO. OF NEW YORK | 2,527 | $548K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE INC | 6,186 | $2.1M |
| Other(6 contracts, 2 carriers) | FIRST SYMETRA NATIONAL LIFE INSURANCE CO. OF NEW YORK | 2,527 | $466K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,186 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.