| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ARIA INSURANCE BROKERAGE INC3 | 371 MERRICK ROAD, SUITE 403 ROCKVILLE CENTRE, NY 11570 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Contract Administrator; Float revenue Service code 12 | — | $1.5M |
| UFCW LOCAL 1500 EIN 13-5342295 AFFILIATED LOCAL UNION | Other services Service code 49 | — | $1.5M |
| ASSOCIATED ADMINISTRATORS, LLC EIN 65-1205077 CONTRACT ADMINISTRATOR | Participant communication; Account maintenance fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Copying and duplicating Service code 12 | — | $1.3M |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing Service code 12 | — | $214K |
| SEI INVESTMENT MANAGEMENT CORP EIN 23-1707341 NONE | Trustee (discretionary); Investment management; Float revenue; Trustee (bank, trust company, or similar financial institution); Investment management fees paid indirectly by plan; Investment management fees paid directly by plan Service code 21 | — | $89K |
| ARIA EMPLOYEE BENEFIT SERVICES EIN 46-0666987 NONE | Consulting (general) Service code 16 | — | $67K |
| ARCHER, BYINGTON, GLENNON & LEVINE EIN 26-0873462 NONE | Legal Service code 29 | — | $51K |
| BERDON LLP EIN 13-0485070 NONE | Accounting (including auditing) Service code 10 | — | $42K |
| BLUE CROSS BLUE SHIELD NONE | Claims processing Service code 12 | 3350 PEACHTREE ROAD NE ATLANTA, GA 30326 | $35K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial Service code 11 | — | $25K |
| PAPER & INK GRAPHICS, LLC EIN 27-3610069 NONE | Other services Service code 49 | — | $22K |
| DAVID FISCH & CO CPAS, PC EIN 13-3624679 NONE | Accounting (including auditing) Service code 10 | — | $15K |
| BERTINI CONSULTING GROUP, INC EIN 26-1463863 NONE | Consulting (general) Service code 16 | — | $14K |
| O'SULLIVAN ASSOCIATES, INC EIN 20-8199367 NONE | Actuarial Service code 11 | — | $11K |
| AJV LLC EIN 38-3939564 NONE | Other services Service code 49 | — | $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 | 18,835 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 602 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 19,437 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 19,688 | $477K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 19,688 | $477K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 19,688 | $477K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 19,688 | — |
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.