| 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 | 12.75% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 14.89% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $793 | — | $793 | 15.00% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $782 | — | $782 | 15.01% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $719 | — | $719 | 15.00% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $689 | — | $689 | 16.19% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $495 | — | $495 | 14.99% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $346 | — | $346 | 14.98% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $232 | — | $232 | 15.03% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $110 | — | $110 | 14.97% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $124 | — | $124 | 19.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CROSSROADS HEALTHCARE MANAGEMENT LL EIN 74-3064316 NONE | Other services; Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | 1441 SOUTH AVENUE, SUITE 702 STATEN ISLAND, NY 10314 | $3.2M |
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Direct payment from the plan; Contract Administrator; Float revenue Service code 12 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 462044903 | $1.2M |
| 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 | $912K |
| PROSCRIPT PHARMACY MANAGEMENT LLC EIN 20-1381813 NONE | Direct payment from the plan; Claims processing Service code 12 | 1441 SOUTH AVENUE, SUITE 702 STATEN ISLAND, NY 10314 | $465K |
| 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 | $247K |
| DAVIS VISION INC EIN 11-2358021 NONE | Other services; Claims processing; Direct payment from the plan Service code 12 | 175 EXPRESS ST., P.O. BOX 9122 PLAINVIEW, NY 11803 | $151K |
| 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 | $88K |
| AMALGAMATED LIFE INSURANCE CO EIN 13-5501223 NONE | Claims processing; Insurance agents and brokers; Direct payment from the plan Service code 12 | PO BOX 5429 WHITE PLAINS, NY 106025429 | $78K |
| MUTUAL OF OMAHA NONE | Direct payment from the plan; Claims processing; Other insurance fees and expenses Service code 12 | 76 NORTH BROADWAY IRVINGTON, NJ 10533 | $76K |
| PERFECT PRINTING SOLUTIONS INC EIN 46-1378840 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 34 EAST MAIN STREET 396 SMITHTOWN, NY 117872841 | $76K |
| FIRST UNUM LIFE INSURANCE CO EIN 13-1898173 NONE | Claims processing; Direct payment from the plan; Insurance agents and brokers Service code 12 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $73K |
| SAVASTA AND COMPANY INC EIN 13-3879959 NONE | Actuarial; Direct payment from the plan Service code 11 | 655 THIRD AVENUE, 12TH FLOOR NEW YORK, NY 10017 | $52K |
| DENTAL SERVICES INC EIN 11-2705347 NONE | Claims processing; Other services; Direct payment from the plan Service code 12 | 1640 HEMPSTEAD TURNPIKE EAST MEADOW, NY 11554 | $51K |
| VISION SCREENING INC EIN 11-2358021 NONE | Claims processing; Other services; Direct payment from the plan Service code 12 | 1919 MIDDLE COUNTRY ROAD SUITE 304 CENTEREACH, NY 11720 | $33K |
| DAVID R PFAFF, MD EIN 13-3687263 NONE | Direct payment from the plan; Consulting fees Service code 50 | 1 CHANNEL DRIVE UNIT 1811 MONMOUTH BEACH, NJ 07750 | $27K |
| 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 | $23K |
| PALMER-TANNO AGENCY INC EIN 13-1977110 NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | 33 WEST MAIN STREET SUITE 408 ELMSFORD, NY 10523 | $13K |
| BOSTON TRUST & INVESTMENT MANAGEME EIN 04-2273811 NONE | Investment management fees paid directly by plan; Custodial (securities); Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Investment management; Trustee (directed); Trustee (discretionary) Service code 19 | ONE BEACON STREET BOSTON, MA 02108 | $12K |
| UNITED HEALTHCARE INSURANCE CO EIN 36-2739571 NONE | Other services; Direct payment from the plan Service code 49 | P.O. BOX 5840 CAROL STREAM, IL 601975840 | $11K |
| INVESTMENT CONSULTING SERVICES LLC EIN 32-0016703 NONE | Consulting fees; Direct payment from the plan; Investment advisory (plan) Service code 27 | 2215 YORK ROAD - SUITE 206 OAK BROOK, IL 60523 | $10K |
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 | 5,442 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 660 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 6,102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 716 | $78K |
| Long-term disability(11 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 139 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 716 | — |
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.