| 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 | $91K | $0 | $91K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Float revenue; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Direct payment from the plan Service code 12 | — | $2.3M |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $450K |
| CATHERINE CHASE EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $367K |
| YASIR ELTAYEB EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $296K |
| WILLIAM STANTON EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $240K |
| RICHARD LOPEZ EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $194K |
| BRADY MCGUIRE & STEINBERG, PC EIN 13-4089943 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $187K |
| ANGEL MALDONADO EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $142K |
| THE SEGAL COMPANY (EASTERN STATES) EIN 13-1835864 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $140K |
| JENNIFER MARINO EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $135K |
| TELEMEDICINE MGMT, INC DBA SWIFT MD EIN 26-1306606 NONE | Direct payment from the plan; Other services Service code 49 | — | $126K |
| VINCENT TURANO EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $109K |
| MOHAMED KARAMALI EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| FLORENCE CHASE EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $95K |
| VANESSA ITURRALDE EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $80K |
| OPTUM RX EIN 33-0441200 NONE | Float revenue; Other fees; Direct payment from the plan; Claims processing Service code 12 | — | $75K |
| SYDNEY ADAMO EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $70K |
| EFRAIN A SEGOVIA EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| LETICIA GONZALES EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $67K |
| EMILY GINAS EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| OLIVIA ADAMO EIN 13-6694320 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $54K |
| MICHELLE PAONE EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $54K |
| DENISSE ITURRALDE EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $51K |
| NICOLE PAONE EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $49K |
| FRIDA DAVYDOV EIN 13-6694320 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $38K |
| SAGE ADVISORY SERVICES, LTD. CO. EIN 74-2798841 INVEST MGR | Investment management fees paid directly by plan; Investment management Service code 28 | — | $34K |
| OPTUM RX, INC. | Float revenue; Other fees; Claims processing; Direct payment from the plan Service code 12 | — | $29K |
| WELLS FARGO ADVISORS EIN 34-1542819 NONE | Investment management; Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $19K |
| EVEREADY GRAPHICS EIN 46-3471000 NONE | Other services; Direct payment from the plan Service code 49 | — | $19K |
| MOSAIC DATA SERVICES INC. EIN 27-4716698 NONE | Direct payment from the plan; Other services Service code 49 | — | $10K |
| CLARKE & SAMPSON, INC. EIN 54-0657005 INSURANCE BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $9K |
| ORACLE AMERICA, INC. NONE | Other services; Direct payment from the plan Service code 49 | 12320 ORACLE BLVD COLORADO SPRINGS, CO 80921 | $7K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Investment management fees paid directly by plan; Custodial (securities); Investment management; Investment management fees paid indirectly by plan Service code 19 | — | $4K |
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 | 2,862 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,862 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | THE UNION LABOR LIFE INSURANCE COMPANY | 2,574 | $1.8M |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 386 | $496K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 2,574 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,574 | — |
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.