| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRITY UNDERWRITERS & BROKERS3 Filed as: INTEGRITY UNDERWRITERS AND BROKERS | 4914 WEST GENESSE STREET CAMILLUS, NY 13031 | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NY | $45K | — | $45K | 10.00% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD, 2ND FL HAUPPAUGE, NY 11788 | HARTFORD LIFE AND ACCIDENT | $22K | — | $22K | 10.94% |
| STANLEY RUBENZAHL3 | MAXON ADMINISTRATORS INC 76 NO BROADWAY IRVINGTON, NY 10533 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 1.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DICKINSON GROUP LLC EIN 20-1241472 NONE | Contract Administrator; Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan; Actuarial Service code 11 | — | $647K |
| EMPIRE BLUE CROSS BLUE SHIELD EIN 23-7391136 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $371K |
| DDS SERVICES INC EIN 11-2705346 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $157K |
| SLEVIN & HART EIN 52-1708613 NONE | Legal; Direct payment from the plan Service code 29 | — | $114K |
| AMERICAN HEALTH CARE ADMIN.SERVICES EIN 68-0146015 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $82K |
| AMERICAN HEALTH HOLDING EIN 31-1368946 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $73K |
| COSTAROTHBORT CPAS LLC EIN 46-5286678 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $73K |
| THE SENECA GROUP NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 960 WHEELING ROAD HAUPPAUGE, NY 11788 | $50K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 26-4310632 NONE | Other services; Securities brokerage commissions and fees; Direct payment from the plan; Investment advisory (plan); Securities brokerage; Custodial (securities); Other investment fees and expenses Service code 19 | — | $38K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $28K |
| ERIC OLYNIK NONE | Direct payment from the plan; Trustee (individual) Service code 20 | 50 CHARLES LINDBERGH BLVD UNIONDALE, NY 11553 | $20K |
| BARNES, LACCARINO & SHEPERD LLP NONE | Legal; Accounting (including auditing) Service code 10 | 258 SAW MILL RIVER ROAD ELMSFORD, NY 10523 | $18K |
| INFOCUS ADVISORS DBA HERITAGE RX EIN 90-0768729 NONE | Direct payment from the plan; Consulting fees Service code 50 | — | $15K |
| REYNOLDS CONSULTING SERVICES EIN 20-1899564 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $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 | 1,769 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,777 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,116 | $199K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NY | 1,537 | $449K |
| Other | HARTFORD LIFE AND ACCIDENT | 1,116 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,537 | — |
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.