Sign up free to preview 6 contract rows with premium, retention, and renewal dates
Free accounts unlock saves, downloads, and 3-year history.
Sign up free to preview commissions and fees for 6 broker rows
Free accounts unlock saves, downloads, and 3-year history.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 THIRD PARTY ADMINISTRATOR | Insurance agents and brokers; Non-monetary compensation; Float revenue; Other services; Claims processing; Insurance brokerage commissions and fees; Other commissions; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $369K |
| INGENIORX, INC. EIN 82-3062245 THIRD PARTY ADMINISTRATOR | Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | -$38K |
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 | 540 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 540 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC | 569 | $1.0M |
| Vision | HM LIFE INSURANCE COMPANY (DAVISVISION) | 444 | $64K |
| Life insurance(2 contracts) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 540 | $140K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 171 | $36K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC | 569 | $1.0M |
| Other(2 contracts) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 540 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 569 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.