| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSMED INS AGENCY INC3 | 111 BROOK STREET 3RD FLOOR SCARSDALE, NY 10583 | GUARDIAN | $10K | — | $10K | 2.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 CONTRACT ADMINISTRATOR | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Contract Administrator; Other fees Service code 12 | 11 WEST 42ND STREET NEW YORK, NY 10036 | $3.3M |
| HOUSE STAFF BENEFIT PLAN EIN 13-6203291 ALLOCATED PR & RELATED EX | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $242K |
| STACEY BRAUN ASSOCIATES, INC EIN 13-2884932 INVESTMENT MANAGER | Soft dollars commissions Service code 68 | 377 BROADWAY NEW YORK, NY 10013 | $183K |
| CIR, SEIU EIN 13-2771401 ALLOCATED PR & RELATED EX | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $74K |
| SEGAL COMPANY EIN 13-1835864 ACTUARY, INSURANCE BROKER | Insurance brokerage commissions and fees; Consulting (general); Actuarial; Insurance agents and brokers Service code 11 | 333 WEST 34TH STREET NEW YORK, NY 10001 | $60K |
| STEPHEN M PERLITSH EIN 13-3805593 PARTICIPATING ATTORNEY | Legal Service code 29 | 110 WEST 34TH STREET NEW YORK, NY 10001 | $50K |
| CAROL G DUNHAM, ESQ EIN 26-3452149 PARTICIPATING ATTORNEY | Legal Service code 29 | 954 CARLETON ROAD WESTFIELD, NJ 07090 | $40K |
| ROGOFF & COMPANY PC EIN 13-2688836 AUDITOR | Accounting (including auditing) Service code 10 | 355 LEXINGTON AVE NEW YORK, NY 10017 | $32K |
| KMR SYSTEMS CORPORATION EIN 13-3192128 COMPUTER CONSULTANT | Consulting (general) Service code 16 | 6800 JERICHO TURNPIKE SYOSSET, NY 11791 | $32K |
| MARCO CONSULTING GROUP INC EIN 36-3555078 INVESTMENT MONITOR | Investment advisory (plan) Service code 27 | 550 WEST WASHINGTON CHICAGO, IL 60661 | $32K |
| KENNEDY, JENNIK & MURRAY, PC EIN 22-1919594 LEGAL COUNSEL | Legal Service code 29 | 113 UNIVERSITY PLACE NEW YORK, NY 10003 | $26K |
| HOLTZMAN HELFMAN LLP EIN 20-2560017 COOPERATING ATTORNEY | Legal Service code 29 | 350 SEVENTH AVE NEW YORK, NY 10001 | $12K |
| GRAD & WEINRAUB LLP EIN 13-3833048 | Legal Service code 29 | — | $8K |
| JM PENSION ADVISORY INC EIN 52-1910770 INDEPENDENT FIDUCIARY | Named fiduciary Service code 31 | — | $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 | 4,369 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 143 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,512 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 3,168 | $1.1M |
| Life insurance | GUARDIAN | 3,665 | $411K |
| Long-term disability | GUARDIAN | 3,665 | $411K |
| Stop-loss / reinsurancereinsurance | SUN LIFE AND HEALTH INSURANCE COMPANY (US) | 3,226 | $970K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,665 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.