| 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 | $78K | $0 | $78K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE INC. EIN 23-7391136 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $2.1M |
| SCHULTHEIS & PANETTIERI LLP EIN 13-1577780 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $562K |
| CATHERINE CHASE EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $343K |
| YASIR ELTAYEB EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $267K |
| WILLIAM STANTON EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $241K |
| RICHARD LOPEZ EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $176K |
| BRADY MCGUIRE & STEINBERG, PC EIN 13-4089943 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $169K |
| TELEMEDICINE MANANGEMENT, INC. EIN 26-1306606 NONE | Direct payment from the plan; Other services Service code 49 | — | $136K |
| MOHAMED KARAMALI EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $126K |
| SAGE ADVISORY SERVICES, LTD. CO. EIN 74-2798841 INVEST MGR | Investment management; Investment management fees paid directly by plan Service code 28 | — | $121K |
| THE SEGAL COMPANY (EASTERN STATES) EIN 13-1835864 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $118K |
| ANGEL MALDONADO EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $107K |
| LAURA ADDUCHIO EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $105K |
| KATHERINE CLANCY EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $105K |
| JENNIFER MARINO EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| FLORENCE CHASE EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $88K |
| OMILLA SINGH EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $74K |
| MICHELLE PAONE EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $72K |
| MARY VENEZIA EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| LETICIA GONZALES EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $62K |
| VANESSA ITURRALDE EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $59K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Float revenue; Claims processing; Direct payment from the plan; Other fees Service code 12 | — | $58K |
| EFRAIN A SEGOVIA EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| VINCENT TURANO EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $57K |
| SYDNEY ADAMO EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $57K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Investment management fees paid indirectly by plan; Custodial (securities); Investment management fees paid directly by plan; Investment management Service code 19 | — | $50K |
| DENISSE ITURRALDE EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $46K |
| ANDERSON ANZIANI EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $43K |
| NICOLE PAONE EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $30K |
| EVEREADY GRAPHICS EIN 46-3471000 NONE | Direct payment from the plan; Other services Service code 49 | — | $30K |
| GRM INFORMATION MANAGEMENT EIN 13-3468713 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $28K |
| CLARKE & SAMPSON, INC | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $10K |
| MOSAIC DATA SERVICES INC. EIN 27-4716698 NONE | Direct payment from the plan; Other services Service code 49 | — | $5K |
| HAMPTON GRAPHICS EIN 37-1698065 NONE | Direct payment from the plan; Other services Service code 49 | — | $5K |
| 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 | 2,953 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,953 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | THE UNION LABOR LIFE INSURANCE COMPANY | 2,896 | $1.6M |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 461 | $489K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 2,896 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,896 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.