| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VAN VALEN ASSOCIATES LTD.3 | 50 CARMEN VIEW DRIVE SHIRLEY, NY 11967 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $21K | — | $21K | — |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | — | — | $0 | — |
| NICOLE WHITMORE3 | 198 HEBERTON AVENUE STATEN ISLAND, NY 10302 | INTEGON NATIONAL INSURANCE COMPANY | $24K | $14K | $38K | — |
| MEDOVA HEALTHCARE5 | 345 N. RIVERVIEW, SUITE 600 WICHITA, KS 67203 | INTEGON NATIONAL INSURANCE COMPANY | — | — | $0 | — |
| TRANSPARENT HEALTHCARE GROUP4 | 630 FAIRVIEW ROAD, SUITE 201 SWARTHMORE, PA 19081 | INTEGON NATIONAL INSURANCE COMPANY | — | — | $0 | — |
| MAGNACARE NETWORK4 | 1600 STEWART AVE STE 700 WESTBURY, NY 11590 | INTEGON NATIONAL INSURANCE COMPANY | — | — | $0 | — |
| CARE ADVOCATES4 | 345 N. RIVERVIEW, SUITE 600 WICHITA, KS 67203 | INTEGON NATIONAL INSURANCE COMPANY | — | — | $0 | — |
| PHCS4 Filed as: MULTIPLAN INC - PHCS | PO BOX 29380 NEW YORK, NY 10087 | INTEGON NATIONAL INSURANCE COMPANY | — | — | $0 | — |
| JEFF ADAMS6 | ONE NATIONWIDE LIFE INSURANCE CO COLUMBUS, OH 43215 | NATIONWIDE LIFE INSURANCE COMPANY | $75K | $9K | $84K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ISABEL VAZQUEZ EIN 13-4191811 EMPLOYEE | Direct payment from the plan Service code 50 | — | $111K |
| GLORIA LARRONDO EIN 13-4191811 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $49K |
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 | 322 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 165 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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."
No prospect flags tripped on this filing.