| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| QUANTUM FINANCIAL STRATEGIES3 | 500 MAMARONECK AVENUE HARRISON, NY 10528 | AMALGAMATED LIFE INSURANCE COMPANY | — | $339 | $339 | 6.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 CLAIMS PROCESSING | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | 1351 WM HOWARD TAFT ROAD CINCINNATI, OH 45206 | $111K |
| ALICARE, INC. EIN 13-3432221 CLAIMS PROCESSING | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | $106K |
| MADISON CONSULTING SERVICES EIN 13-4017745 MEDICAL CONSULTING | Consulting (general); Direct payment from the plan Service code 16 | 100 SOUTH BEDFORD ROAD SUITE 340 MOUNT KISCO, NY 10549 | $71K |
| SILVIA PEREZ EIN 13-6179467 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 629 FIFTH AVENUE PELHAM, NY 10803 | $38K |
| PETER VAUPEL EIN 13-6179467 PRESIDENT | Direct payment from the plan; Plan Administrator Service code 14 | 629 FIFTH AVENUE PELHAM, NY 10803 | $37K |
| WAGNER & ZWERMAN LLP EIN 11-2836481 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 450 WIRELESS BLVD HAUPPAUGE, NY 11788 | $23K |
| BARNES, IACCARINO & SHEPHERD LLP EIN 26-3858697 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 3 SURREY LANE HEMPSTEAD, NY 11550 | $22K |
| CYNOMYS INC EIN 22-3007300 ACTUARIAL | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | 271 PARK VIEW AVENUE YONKERS, NY 10710 | $18K |
| DD SERVICES, INC. EIN 11-2705347 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | 1640 HEMPSTEAD TPKE EAST MEADOW, NY 11554 | $8K |
| CVS PHARMACY, INC. EIN 05-0340626 CLAIMS PROCESSING | Claims processing; Direct payment from the plan Service code 12 | 695 GEORGE WASHINGTON HWY LINCOLN, RI 02865 | $5K |
| OPTUM RX, INC. EIN 33-0441200 CLAIMS PROCESSING | Direct payment from the plan; Claims processing; Other fees; Float revenue Service code 12 | 2300 MAIN STREET IRVINE, CA 92614 | $0 |
| OPTUM RX, INC. 33-0441200 | Float revenue; Other fees; Direct payment from the plan; Claims processing Service code 12 | — | $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 | 290 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 326 | $6K |
| Stop-loss / reinsurancereinsurance | STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 295 | $340K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.