| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBS INSURANCE BROKERAGE AND FINAN3 | ONE JERICHO PLAZA, STE 200 JERICHO, NY 11753 | HIGHMARK BLUESHIELD OF NORTHEASTERN NY | $44K | — | $44K | 3.38% |
| JOHN H BLASCH3 | 71 BEECHWOOD LANE BERKELEY HEIGHTS, NJ 07922 | SYMETRA LIFE INSURANCE COMPANY | $93K | — | $93K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 300 MADISON AVE, 28TH FLR NEW YORK, NY 10017 | MVP HEALTHCARE | $7K | — | $7K | 3.92% |
| JOHN H BLASCH3 | 71 BEECHWOOD LANE BERKELEY HEIGHTS, NJ 07922 | SYMETRA LIFE INSURANCE COMPANY | $8K | — | $8K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAGNACARE EIN 11-3410766 NONE | Claims processing; Other insurance fees and expenses; Direct payment from the plan; Other services Service code 12 | — | $1.4M |
| MARSHALL AND MOSS LLP EIN 11-3360166 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $826K |
| BARNES,IACCARINO & SHEPHERD LLP EIN 26-3858697 NONE | Legal; Direct payment from the plan Service code 29 | — | $349K |
| THE SEGAL COMPANY INC EIN 13-1835864 NONE | Direct payment from the plan; Actuarial; Consulting (pension) Service code 11 | — | $310K |
| EMPIRX HEALTH LLC EIN 47-1226691 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $301K |
| STACY PECCHIA EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $258K |
| BRIDGEWAY BENEFIT TEHCNOLOGIES EIN 52-1796473 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $251K |
| GALLAGHER BENEFIT SERVICES INC EIN 36-2481781 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $250K |
| AURELIA CIOCOI EIN 13-5600369 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $243K |
| ROCIO GARCIA EIN 13-5600369 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $194K |
| METROPOLITAN MANAGEMENT INC EIN 45-3845437 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $173K |
| WORKFORCE ASSISTANCE PROGRAM EIN 20-8231145 NONE | Other services; Other insurance fees and expenses Service code 49 | — | $169K |
| KEVIN MCMENOMY EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $145K |
| GENERAL VISION SERVICES LLC EIN 11-3580576 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $135K |
| MONICA ORTIZ EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $132K |
| KOBGO ASSOCIATES INC EIN 13-2751089 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $123K |
| KIMBERLY LAUGHTON EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $115K |
| ASHLEY NIEVES EIN 13-5600369 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $111K |
| CARLA PICKNEY EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $111K |
| SALVATORE SAVARESE EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $106K |
| LAMONA MITCHELL EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $100K |
| ADMINSTRATIVE SERVICES ONLY INC EIN 11-2995970 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $95K |
| UHY ADVISORS NY INC EIN 14-1555429 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $91K |
| DAVIS VISION INC EIN 11-3051991 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $88K |
| STEVEN SALZMAN EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| ULLICO INVESTMENT ADVISORS INC EIN 52-6435649 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $73K |
| PROSKAUER ROSE LLP EIN 13-1840454 NONE | Legal; Direct payment from the plan Service code 29 | — | $73K |
| MIRIAM MOGOLLON EIN 13-5600369 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| GEORGEANNE MAMAKAS EIN 13-5600369 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| DEBORAH HEIBISCH EIN 13-5600369 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $61K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $61K |
| INTERCONTINENTAL REAL ESTATE EIN 13-3786306 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $59K |
| JONATHAN MOSTAFA EIN 13-5600369 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $54K |
| ERIC KATECHIS EIN 13-5600369 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $52K |
| CELESTE BALLARD EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $48K |
| VISION SCREENING INC EIN 06-1434201 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $48K |
| WHITNEY JENKINS EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $47K |
| FOUNDRY PARTNERS LLC EIN 46-1184506 NONE | Investment management; Soft dollars commissions; Investment management fees paid directly by plan; Securities brokerage commissions and fees Service code 28 | — | $46K |
| PATRICK JOSEPH EIN 13-5600369 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $45K |
| MARITZA BORBON EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $40K |
| SEGAL SELECT INSURANCE SERVICES EIN 46-0619194 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $39K |
| AETNA EIN 23-2229683 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $39K |
| AINSWORTH INC EIN 83-1674559 NONE | Other services; Direct payment from the plan Service code 49 | — | $38K |
| ASSETMARK TRUST COMPANY EIN 30-0774039 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $36K |
| ANNETTE CHEVALIER EIN 13-5600369 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $33K |
| SEBASTIAN ROMERO EIN 13-5600369 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $32K |
| LOOMIS SAYLES TRUST COMPANY EIN 20-8080381 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $32K |
| WASTE CONNECTIONS INC EIN 68-0400286 NONE | Direct payment from the plan; Other services Service code 49 | — | $28K |
| METROPOLITAN TEMPORARIES EIN 13-3423067 NONE | Direct payment from the plan; Other services Service code 49 | — | $24K |
| UNI PRINTING SOLUTIONS LLC NONE | Direct payment from the plan; Participant communication Service code 38 | 42 READS WAY NEW CASTLE, DE 19720 | $23K |
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 | 4,871 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 639 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,510 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK BLUESHIELD OF NORTHEASTERN NY | 130 | $1.3M |
| Dental | THE UNION LABOR LIFE INSURANCE COMPANY | 90 | $12K |
| Life insurance(3 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 90 | $515K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 0 | $466K |
| Prescription drug | HIGHMARK BLUESHIELD OF NORTHEASTERN NY | 130 | $1.3M |
| Other(3 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 90 | $515K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 697 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.