| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ARIA INSURANCE BROKERAGE INC3 | 371 MERRICK ROAD, SUITE 403 ROCKVILLE CENTRE, NY 11570 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $3K | — | $3K | 1.01% |
| ARIA INSURANCE BROKERAGE INC3 | 371 MERRICK ROAD, SUITE 403 ROCKVILLE CENTRE, NY 11570 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $2K | — | $2K | 1.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UFCW LOCAL 1500 EIN 13-5342295 AFFILIATED LOCAL UNION | Other services Service code 49 | — | $1.7M |
| ASSOCIATED ADMINISTRATORS, LLC EIN 65-1205077 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing; Copying and duplicating Service code 12 | — | $1.4M |
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $899K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing Service code 12 | — | $708K |
| UFCW LOCAL 1500 BUILDING, INC EIN 11-2569806 AFFILIATED BUILDING CORP | Other services Service code 49 | — | $324K |
| SEI INVESTMENT MANAGEMENT CORP EIN 23-1707341 NONE | Investment advisory (plan); Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Float revenue; Custodial (securities); Investment management Service code 19 | — | $123K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial Service code 11 | — | $91K |
| ARIA EMPLOYEE BENEFIT SERVICES EIN 46-0666987 NONE | Consulting (general) Service code 16 | — | $71K |
| ARCHER, BYINGTON, GLENNON & LEVINE EIN 26-0873462 NONE | Legal Service code 29 | — | $56K |
| CITRIN COOPERMAN & COMPANY LLP EIN 22-2428965 NONE | Accounting (including auditing) Service code 10 | — | $46K |
| AJV LLC EIN 38-3939564 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $11K |
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 | 13,208 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 286 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 13,494 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 13,170 | $515K |
| Other(2 contracts) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 13,170 | $515K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,170 | — |
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."
No prospect flags tripped on this filing.