No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services Service code 12 | — | $140K |
| RANDY PAUL EIN 13-3819669 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $110K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $91K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 NONE | Claims processing Service code 12 | 2601 W. BELTLINE HIGHWAY MADISON, WI 53713 | $59K |
| ANNEL ORTIZ EIN 13-3819669 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $54K |
| DONNA SANTANA EIN 13-3819669 EMPLOYEE | Direct payment from the plan; Employee (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 | $30K |
| SUMMIT ACTUARIAL SERVICES, INC. EIN 20-3838633 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $21K |
| INVESTMENT PERFORMANCE SERVICES EIN 58-2432390 NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | — | $17K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 639 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 639 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTCARE DELIVERY SYSTEMS | 576 | $0 |
| Prescription drug | NAVITUS HEALTH SOLUTIONS | 2,223 | $0 |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 217 | $311K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,223 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.