No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OXFORD HEALTH PLAN EIN 06-1181200 NONE | Insurance services Service code 23 | PO BOX 1697 NEWARK, NJ 07101 | $1.3M |
| CARE CONNECT | Insurance services Service code 23 | 2200 NORTH BLVD EAST HILLS, NY 11548 | $592K |
| NY HEALTHY REPUBLIC NONE | Insurance services Service code 23 | 30 BROAD STREET NEW YORK, NY 10004 | $558K |
| SERVICE STATION DEALERS OF GREAT NY EIN 13-5672542 ASSOCIATION | Contract Administrator Service code 13 | 421 WAVERLY AVNUE MAMARONECK, NY 10543 | $44K |
| GUARDIAN EIN 13-5123390 NONE | Insurance services Service code 23 | PO BOX 824404 PHILADELPHIA, PA 19182 | $42K |
| SHELTER POINT LIFE EIN 11-2284118 NONE | Insurance services Service code 23 | PO BOX 220727 GREAT NECK, NY 11021 | $13K |
| LILLING & COMPANY EIN 13-3447681 NONE | Accounting (including auditing) Service code 10 | 10 CUTTER MILL ROAD GREAT NECK, NY 11021 | $12K |
| EMPIRE BLUE CROSS EIN 23-7391136 5629 | Insurance services Service code 23 | PO BOX 1407 CHURCH ST ST NEW YORK, NY 10008 | $0 |
| LEOTTA & ASSOCIATES CPA PLLC EIN 20-8087020 | Accounting (including auditing) Service code 10 | 175 MAIN STREET NANUET, NY 10954 | $0 |
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 | 210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | BLUE CROSS BLUE SHIELD | 74 | $0 |
| Dental | GUARDIAN DENTAL | 44 | $0 |
| Vision | VSP | 6 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 74 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.