| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RYANN J. MCCARTHY3 | 25 GRIFFIN AVE BEDFORD HILLS, NY 10507 | EMBLEMHEALTH | $287K | — | $287K | 3.00% |
| BENEFIT TECHNOLOGY GROUP, INC.3 | P.O. BOX 513 RIDGE, NY 11961 | AETNA INC. | $2K | — | $2K | 4.36% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LAURIE GRECO EIN 20-3244794 EMPLOYEE | Contract Administrator Service code 13 | 1065 OLD COUNTRY RD WESTBURY, NY 11590 | $143K |
| JACQUELINE ELSNER EIN 20-3244794 EMPLOYEE | Trustee (discretionary) Service code 24 | 1065 OLD COUNTRY RD WESTBURY, NY 11590 | $53K |
| CLAUDIA MARQUEZ EIN 20-3244794 EMPLOYEE | Trustee (discretionary) Service code 24 | 1065 OLD COUNTRY RD WESTBURY, NY 11590 | $50K |
| JACKI MITCHELL EIN 11-4746860 EMPLOYEE | Trustee (discretionary) Service code 24 | 1065 OLD COUNTRY RD WESTBURY, NY 11590 | $37K |
| MARCIA SALOMON EIN 20-3244794 EMPLOYEE | Trustee (discretionary) Service code 24 | 1065 OLD COUNTRY RD WESTBURY, NY 11590 | $29K |
| LINDA MAUGERI EIN 20-3244794 EMPLOYEE | Trustee (discretionary) Service code 24 | 1065 OLD COUNTRY RD WESTBURY, NY 11590 | $25K |
| CATHY VASILE EIN 20-3244794 EMPLOYEE | Trustee (discretionary) Service code 24 | 1065 OLD COUNTRY RD WESTBURY, NY 11590 | $19K |
| ANGELA MCCABE EIN 20-3244794 EMPLOYEE | Trustee (discretionary) Service code 24 | 1065 OLD COUNTRY RD WESTBURY, NY 11590 | $16K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,035 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,035 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMBLEMHEALTH | 1,029 | $9.6M |
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 612 | $26K |
| Prescription drug | EMBLEMHEALTH | 1,029 | $9.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,029 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.