| 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 | 13.06% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 12.97% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $851 | — | $851 | 15.01% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $842 | — | $842 | 15.00% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $716 | — | $716 | 14.02% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $652 | — | $652 | 15.01% |
| 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 | $373 | — | $373 | 15.02% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 100.00% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $164 | — | $164 | 12.36% |
| ALICARE, INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | FIRST UNUM LIFE INSURANCE COMPANY | $101 | — | $101 | 15.01% |
| 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 | 1441 SOUTH AVENUE, SUITE 702 STATEN ISLAND, NY 10314 | $3.3M |
| EMPIRE BLUE CROSS BLUE SHIELD EIN 23-7391136 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 462044903 | $2.4M |
| 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 | $581K |
| 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 | $223K |
| DAVIS VISION INC EIN 11-2358021 NONE | Direct payment from the plan; Other services; Claims processing Service code 12 | 175 EXPRESS ST., P.O. BOX 9122 PLAINVIEW, NY 11803 | $165K |
| SAMUEL GOLDSTEIN & CO., P.C. EIN 11-2478817 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 150 GREAT NECK ROAD - SUITE 202 GREAT NECK, NY 11021 | $90K |
| AMALGAMATED LIFE INSURANCE CO EIN 13-5501223 NONE | Insurance agents and brokers; Direct payment from the plan; Claims processing Service code 12 | PO BOX 5429 WHITE PLAINS, NY 106025429 | $78K |
| FIRST UNUM LIFE INSURANCE CO EIN 13-1898173 NONE | Insurance agents and brokers; Claims processing; Direct payment from the plan Service code 12 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $74K |
| 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 | $69K |
| SAVASTA AND COMPANY INC EIN 13-3879959 NONE | Direct payment from the plan; Actuarial Service code 11 | 655 THIRD AVENUE, 12TH FLOOR NEW YORK, NY 10017 | $52K |
| DENTAL SERVICES INC EIN 11-2705347 NONE | Other services; Direct payment from the plan; Claims processing Service code 12 | 1640 HEMPSTEAD TURNPIKE EAST MEADOW, NY 11554 | $50K |
| 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 | $36K |
| VISION SCREENING INC EIN 11-2358021 NONE | Other services; Direct payment from the plan; Claims processing Service code 12 | 1919 MIDDLE COUNTRY ROAD SUITE 304 CENTEREACH, NY 11720 | $28K |
| 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 | $17K |
| 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 | $15K |
| PALMER-TANNO AGENCY INC EIN 13-1977110 NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | 33 WEST MAIN STREET SUITE 408 ELMSFORD, NY 10523 | $14K |
| ZIEGLER CAPITAL MANAGEMENT LLC EIN 85-0597999 NONE | Investment management fees paid directly by plan Service code 51 | 30 S. WACKER DRIVE, SUITE 2800 CHICAGO, IL 60606 | $9K |
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 | 5,613 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 367 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,980 | 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 | 131 | $76K |
| 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.