| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 14.12% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 14.39% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $827 | — | $827 | 16.44% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $766 | — | $766 | 16.31% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $685 | — | $685 | 16.22% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $690 | — | $690 | 16.38% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $641 | — | $641 | 16.23% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $496 | — | $496 | 16.39% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $344 | — | $344 | 16.33% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $163 | — | $163 | 16.45% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $147 | — | $147 | 16.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CROSSROADS HEALTHCARE MANAGEMENT LL EIN 74-3064316 NONE | Other services; Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | 2556 ARTHUR KILL ROAD STATEN ISLAND, NY 10309 | $3.1M |
| NEW YORK PUBLIC GOODS POOL EIN 15-0329043 NONE | Other services; Direct payment from the plan Service code 49 | CENTRAL NY REGION P.O. BOX 4757 SYRACUSE, NY 132214757 | $992K |
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Float revenue; Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator Service code 12 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 462044903 | $976K |
| PROSCRIPT PHARMACY MANAGEMENT LLC EIN 20-1381813 NONE | Claims processing; Direct payment from the plan Service code 12 | 2556 ARTHUR KILL ROAD STATEN ISLAND, NY 10309 | $382K |
| LAW OFFICES OF THOMAS A. THOMPSON NONE | Legal; Direct payment from the plan Service code 29 | 148 WHITES COVE ROAD, SUITE 1 YARMOUTH, ME 04096 | $326K |
| DENTAL SERVICES INC EIN 11-2705347 NONE | Claims processing; Direct payment from the plan; Other services Service code 12 | 1640 HEMPSTEAD TURNPIKE EAST MEADOW, NY 11554 | $240K |
| DAVIS VISION INC EIN 11-2358021 NONE | Direct payment from the plan; Claims processing; Other services Service code 12 | 175 EXPRESS ST., P.O. BOX 9122 PLAINVIEW, NY 11803 | $146K |
| MUTUAL OF OMAHA NONE | Other insurance fees and expenses; Direct payment from the plan; Claims processing Service code 12 | 76 NORTH BROADWAY IRVINGTON, NJ 10533 | $89K |
| SAMUEL GOLDSTEIN & CO., P.C. EIN 11-2478817 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 150 GREAT NECK ROAD - SUITE 202 GREAT NECK, NY 11021 | $89K |
| FIRST UNUM LIFE INSURANCE CO EIN 13-1898173 NONE | Direct payment from the plan; Claims processing; Insurance agents and brokers Service code 12 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $79K |
| AMALGAMATED LIFE INSURANCE CO NONE | Claims processing; Insurance agents and brokers; Direct payment from the plan Service code 12 | PO BOX 5429 WHITE PLAINS, NY 106025429 | $78K |
| VISION SCREENING INC EIN 11-2358021 NONE | Direct payment from the plan; Other services; Claims processing Service code 12 | 1919 MIDDLE COUNTRY ROAD SUITE 304 CENTEREACH, NY 11720 | $38K |
| SAVASTA AND COMPANY INC EIN 13-3879959 NONE | Direct payment from the plan; Actuarial Service code 11 | SIXTY BROAD STREET - 37TH FLOOR NEW YORK, NY 10004 | $36K |
| PERFECT PRINTING SOLUTIONS INC EIN 46-1378840 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 34 EAST MAIN STREET 396 SMITHTOWN, NY 117872841 | $34K |
| DAVID R PFAFF, MD EIN 13-3687263 NONE | Direct payment from the plan; Consulting fees Service code 50 | 3311 HYLAN BLVD STATEN ISLAND, NY 10306 | $24K |
| GENERAL VISION SERVICES LLC EIN 11-3580756 NONE | Claims processing; Other services; Direct payment from the plan Service code 12 | P.O. BOX 8000, DEPT 79 BUFFALO, NY 14267 | $17K |
| INVESTMENT CONSULTING SERVICES LLC EIN 32-0016703 NONE | Investment advisory (plan); Consulting fees; Direct payment from the plan Service code 27 | 2215 YORK ROAD - SUITE 206 OAK BROOK, IL 60523 | $9K |
| C. S. MCKEE, L.P. EIN 25-1900687 NONE | Direct payment from the plan; Investment management fees paid directly by plan; Investment management Service code 28 | ONE GATEWAY CENTER, 8TH FLOOR PITTSBURGH, PA 15239 | $8K |
| M & T BANK INSTIT RETIREMENT SERVIC EIN 16-0538020 NONE | Custodial (securities); Direct payment from the plan; Float revenue Service code 19 | 285 DELAWARE AVENUE, 3RD FLOOR BUFFALO, NY 14202 | $5K |
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 | 4,945 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 686 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,631 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 719 | $78K |
| Long-term disability(11 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 139 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 719 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.