No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Claims processing; Other services; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $337K |
| RANDY PAUL EIN 13-3819669 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $110K |
| ANNEL ORTIZ EIN 13-3819669 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $54K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $50K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 NONE | Claims processing Service code 12 | 2601 W. BELTLINE HIGHWAY MADISON, WI 53713 | $48K |
| DONNA SANTANA EIN 13-3819669 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $36K |
| ARCHER BYINGTON GLENNON & LEVINE NONE | Legal; Direct payment from the plan Service code 29 | ONE HUNTINGTON QUADRANGLE MELVILLE, NY 11747 | $31K |
| INVESTMENT PERFORMANCE SERVICES EIN 58-2432390 NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $23K |
| SUMMIT ACTUARIAL SERVICES, INC. EIN 20-3838633 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $21K |
| SEGALL BRYANT & HAMILL EIN 41-1788385 NONE | Investment management fees paid directly by plan; Soft dollars commissions; Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $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 | 733 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 736 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTCARE DELIVERY SYSTEMS | 679 | $103K |
| Prescription drug | NAVITUS HEALTH SOLUTIONS | 1,249 | $0 |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 0 | $413K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,249 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.