| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GFI INSURANCE BROKERAGE3 | 140 BROADWAY, 41ST FLOOR NEW YORK, NY 10005 | MIDLANDS CASUALTY INSURANCE CO. | $15K | $0 | $15K | 6.57% |
| TRANSPARENT HEALTHCARE GROUP4 Filed as: TRANSPARENT HEALTHCARE | 630 FAIRVIEW ROAD SUITE 201 SWARTHMORE, PA 19081 | MIDLANDS CASUALTY INSURANCE CO. | $0 | $9K | $9K | 3.76% |
| MEDOVA HEALTHCARE5 Filed as: MEDOVA HEALTCARE | 345 N. RIVERVIEW STREET, SUITE 600 WICHITA, KS 67203 | MIDLANDS CASUALTY INSURANCE CO. | $0 | $9K | $9K | 3.76% |
| MAGNACARE NETWORK4 | 1600 STEWART AVENUE, SUITE 700 WESTBURY, NY 115906663 | MIDLANDS CASUALTY INSURANCE CO. | $0 | $7K | $7K | 2.93% |
| RBI INSURANCE3 | 250 CROSSWAYS PARK DRIVE WOODBURY, NY 11797 | MIDLANDS CASUALTY INSURANCE CO. | $7K | $0 | $7K | 2.90% |
| PHCS3 Filed as: MULTIPLAN INC. - PHCS | PO BOX 29380 GENERAL POST OFFICE NEW YORK, NY 100879380 | MIDLANDS CASUALTY INSURANCE CO. | $0 | $12 | $12 | 0.01% |
| GFI INSURANCE BROKERAGE3 | 140 BROADWAY, 41ST FLOOR NEW YORK, NY 10005 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $7K | $0 | $7K | 4.08% |
| VAN VALEN ASSOCIATES LTD.3 | 50 CARMEN VIEW DRIVE SHIRLEY, NY 11967 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $1K | $0 | $1K | 0.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ISABEL VAZQUEZ EIN 13-4191811 EMPLOYEE | Plan Administrator; Employee (plan); Direct payment from the plan Service code 14 | — | $90K |
| JOSE VEGA EIN 13-4191811 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $73K |
| GLORIA LARRONDO EIN 13-4191811 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $39K |
| COSTAROTHBORT CPAS, LLC EIN 46-5286678 AUDITORS | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $12K |
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 | 151 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | MIDLANDS CASUALTY INSURANCE CO. | 97 | $401K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 97 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.