| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WESTWOOD PLANS, INC.3 | 6 WHITE PINE LANE SETAUKET, NY 11733 | OXFORD HEALTH INSURANCE, INC | $5K | — | $5K | 3.25% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD SUITE 200 HAUPPAUGE, NY 11788 | OXFORD HEALTH INSURANCE, INC | — | $1K | $1K | 0.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MICHAEL WIEDERHOLD EIN 13-6162367 EMPLOYEE | Employee (plan) Service code 30 | — | $84K |
| EDWIN ORTIZ EIN 13-6162367 NONE | Employee (plan) Service code 30 | — | $54K |
| WILLIAM SIMPKINS EIN 13-6162367 NONE | Employee (plan) Service code 30 | — | $49K |
| ELLEN ESCHUCK EIN 13-6162367 NONE | Employee (plan) Service code 30 | — | $47K |
| MARIAN OCONNOR EIN 13-6162367 NONE | Employee (plan) Service code 30 | — | $42K |
| MARITZA DIAZ EIN 13-6162367 NONE | Employee (plan) Service code 30 | — | $36K |
| BLACKROCK INVESTMENT MANAGEMENT, LL EIN 20-5319476 UNION INVESTMENT MANAGER | Investment management fees paid directly by plan; Direct payment from the plan; Investment management Service code 28 | — | $35K |
| GOULD, KOBRICK & SCHLAPP EIN 13-3082707 NONE | Accounting (including auditing) Service code 10 | — | $29K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Consulting (general); Actuarial Service code 11 | — | $25K |
| SYNTONIC SYSTEMS EIN 13-2925049 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $23K |
| EISNER & MIRER P.C. EIN 13-3062532 UNION ATTORNEY | Legal Service code 29 | — | $19K |
| UNITED STOREWORKERS, R.W.D.S.U., L3 EIN 13-2630482 UNION | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $14K |
| MSI TECHNOLOGIES LLC NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $7K |
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 | 762 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 527 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,289 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OXFORD HEALTH INSURANCE, INC | 12 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12 | — |
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.