| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: CLARKE & SAMPSON, INC. | 228 S WASHINGTON ST. SUITE 200 ALEXANDRIA, VA 22314 | THE UNION LABOR LIFE INSURANCE COMPANY | $29K | $0 | $29K | 2.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE INC. EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue; Other services; Direct payment from the plan Service code 12 | — | $2.1M |
| SCHULTHEIS & PANETTIERI LLP EIN 13-1577780 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $407K |
| CATHERINE CHASE EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $332K |
| WILLIAM STANTON EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $235K |
| YASIR ELTAYEB EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $227K |
| LAURA ADDUCHIO EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $179K |
| BRADY MCGUIRE & STEINBERG, PC EIN 13-4089943 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $173K |
| RICHARD LOPEZ EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $169K |
| MOHAMED KARAMALI EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $127K |
| TELEMEDICINE MANANGEMENT, INC. EIN 26-1306606 NONE | Direct payment from the plan; Other services Service code 49 | — | $125K |
| RICHARD VENEZIA EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $125K |
| KATHERINE CLANCY EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $116K |
| SAGE ADVISORY SERVICES, LTD. CO. EIN 74-2798841 INVEST MGR | Investment management fees paid directly by plan; Investment management Service code 28 | — | $112K |
| JENNIFER MARINO EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $88K |
| FLORENCE CHASE EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $86K |
| ANGEL MALDONADO EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| OMILLA SINGH EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| VANESSA ITURRALDE EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $72K |
| MICHELLE PAONE EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| MARY VENEZIA EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $65K |
| LETICIA GONZALES EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $61K |
| EFRAIN A SEGOVIA EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $56K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Float revenue; Other fees; Claims processing; Direct payment from the plan Service code 12 | — | $54K |
| NICOLE PAONE EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $52K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Custodial (securities); Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Investment management Service code 19 | — | $51K |
| THE SEGAL COMPANY (EASTERN STATES) EIN 13-1835864 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $51K |
| SAFEGUARD BUSINESS SYSTEMS EIN 23-1689322 NONE | Other services; Direct payment from the plan Service code 49 | — | $45K |
| DENISSE ITURRALDE EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $45K |
| SYDNEY ADAMO EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $43K |
| EVEREADY GRAPHICS EIN 46-3471000 NONE | Other services; Direct payment from the plan Service code 49 | — | $43K |
| GRM INFORMATION MANAGEMENT EIN 13-3468713 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $33K |
| BASIL CASTROVINCI ASSOC., INC. EIN 13-2831500 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $18K |
| CLARKE & SAMPSON, INC | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $8K |
| MOSAIC DATA SERVICES INC. EIN 27-4716698 NONE | Direct payment from the plan; Other services Service code 49 | — | $5K |
| CLARKE & SAMPSON, INC. | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $2K |
| CLARKE & SAMPSON INC. EIN 54-0657005 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $0 |
| OPTUMRX, INC | Other fees Service code 99 | — | $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 | 3,141 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | THE UNION LABOR LIFE INSURANCE COMPANY | 2,361 | $1.0M |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 502 | $474K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 2,361 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,361 | — |
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."
No prospect flags tripped on this filing.