| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| QUANTUM FINANCIAL STRATEGIES3 | 500 MAMARONECK AVENUE HARRISON, NY 10528 | AMALGAMATED LIFE INSURANCE COMPANY | $359 | — | $359 | 5.64% |
| JACK E WILSON3 Filed as: JACK WILSON | 320 LUPINE DR KNOXVILLE, TN 37924 | AFLAC | $180 | — | $180 | 5.94% |
| PACKES J D CORP3 | 92 NORTH AVENUE SUITE 102 NEW ROCHELLE, NY 10801 | AFLAC | $67 | — | $67 | 2.21% |
| AMERICAN TEL-TEK INC.3 | 92 NORTH AVENUE STE 102 NEW ROCHELLE, NY 10801 | AFLAC | $41 | — | $41 | 1.35% |
| KEVIN MCCARTHY3 | 197 LANG DR NORTH KINGSTOWN, RI 02852 | AFLAC | $40 | — | $40 | 1.32% |
| DOMINICK R SIRACUSA3 Filed as: DOMINICK SIRACUSA | 225 DOLSON AVE SUITE 304 MIDDLETOWN, NY 10940 | AFLAC | $18 | — | $18 | 0.59% |
| MCINERNEY GROUP LLC3 | 580 WHITE PLAINS ROAD SUITE 115 TARRYTOWN, NY 10591 | AFLAC | $9 | — | $9 | 0.30% |
| MELISA SCHOFIELD3 | 932 E VOLK LN MIDDLETOWN, CT 06457 | AFLAC | $4 | — | $4 | 0.13% |
| WENDY CALIENDO3 Filed as: WENDY M CALIENDO | 1036 MAGGIE RD NEWBURGH, NY 12550 | AFLAC | $1 | — | $1 | 0.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 CLAIMS PROCESSING | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Float revenue Service code 12 | 14 WALL STREET NEW YORK, NY 10005 | $108K |
| ALICARE, INC. EIN 13-3432221 CLAIMS PROCESSING | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | $84K |
| QUANTUM FINANCIAL STRATEGIES EIN 13-4017745 MEDICAL CONSULTING | Consulting (general); Direct payment from the plan Service code 16 | 118 NORTH BEDFORD ROAD MOUNT KISCO, NY 10549 | $75K |
| PETER VAUPEL EIN 13-6179467 PRESIDENT | Direct payment from the plan; Plan Administrator Service code 14 | 629 FIFTH AVENUE PELHAM, NY 10803 | $62K |
| EDUARDO MELENDEZ EIN 13-6179467 SECRETARY/TREASURER | Employee (plan); Direct payment from the plan Service code 30 | 629 FIFTH AVENUE PELHAM, NY 10803 | $32K |
| WAGNER & ZWERMAN LLP EIN 11-2836481 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 201 OLD COUNTRY ROAD STE 202 MELVILLE, NY 117472731 | $30K |
| 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 82-2668930 ACTUARIAL | Actuarial; Consulting (general); Direct payment from the plan Service code 11 | 16170 POPPY SEED CIRCLE UNIT 902 DELRAY BEACH, FL 33484 | $19K |
| ALICARE MEDICAL MANAGEMENT EIN 13-3860528 CLAIMS PROCESSING | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | 8C INDUSTRIAL WAY SALEM, NH 03079 | $15K |
| D.D. 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 | 2215 SANDERS ROAD NBT-5 NORTHBROOK, IL 60062 | $8K |
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. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 292 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | AMALGAMATED LIFE INSURANCE COMPANY | 381 | $9K |
| Stop-loss / reinsurancereinsurance | SIRIUS AMERICA INSURANCE COMPANY | 290 | $343K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 381 | — |
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.