| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALICARE, INC3 Filed as: ALICARE INC | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | HEALTH PLAN OF NEVADA | $101K | — | $101K | 2.08% |
| KORNER & DE GRAFF BENEFITS3 Filed as: KORNER DE GRAFF BENEFITS & CONSULTI | 3149 DUNDEE ROAD NORTHBROOK, IL 600622402 | HMO ILLINOIS | $79K | — | $79K | 4.01% |
| CARLOS DONALD REYNOSO3 | 3039 GOLDEN OAK WAY SPRING VALLEY, CA 91978 | HEALTH NET | $19K | — | $19K | 3.67% |
| CARLOS REYNOSO3 Filed as: CARLOS MONTERO REYNOSO | 1337 PASEO SERNO SAN DIEGO, CA 91773 | HEALTH NET | $6K | — | $6K | 1.22% |
| MYRIAD BENEFITS INC3 Filed as: MYRIAD BENEFITS | PO BOX 1377 GUAYNABO, PR 00970 | MCS LIFE INSURANCE COMPANY | $10K | — | $10K | 6.00% |
| MYRIAD BENEFITS INCORPORATED3 Filed as: MYRIAD BENEFIT.INC | PO BOX 1377 GUAYNABO, PR 009701377 | DELTA DENTAL OF PUERTO RICO, INC | $739 | — | $739 | 8.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALICARE INC. EIN 13-3432221 OWNED BY PARTY-IN-INT | Other services Service code 49 | — | $24.3M |
| ANTHEM BLUE CROSS BLUE SHIELD NONE | Claims processing Service code 12 | 43612 IRWIN SIMPSON ROAD MASON, OH 45040 | $4.0M |
| ALICARE EIN 13-3432221 OWNED BY PARTY-IN-INT | Plan Administrator Service code 14 | — | $3.2M |
| ALICARE MEDICAL MANAGEMENT, INC EIN 13-3860528 OWNED BY PARTY-IN-INT | Other services Service code 49 | — | $2.6M |
| UNITE HERE HEALTH CENTER EIN 13-5563408 PARTY-IN-INT | Contract Administrator Service code 13 | — | $2.4M |
| BLUE CROSS BLUE SHIELD OF MASSACHUS EIN 04-1045815 NONE | Claims processing Service code 12 | — | $2.1M |
| EXPRESS SCRIPT, INC. (MEDCO MANAGED EIN 43-1420563 NONE | Other fees; Claims processing; Contract Administrator Service code 12 | — | $465K |
| SIDNEY HILLMAN HEALTH CENTER EIN 36-2245908 PARTY-IN-INT | Claims processing Service code 12 | — | $363K |
| NEW YORK NEW JERSEY REGIONAL JT BD EIN 13-4908365 PARTY-IN-INT | Plan Administrator Service code 14 | — | $298K |
| ALIGRAPHICS, A DIVISION OF ALICARE, EIN 13-3432221 OWNED BY PARTY-IN-INT | Other services Service code 49 | — | $278K |
| SCHULTE ROTH & ZABEL LLP EIN 13-2633996 NONE | Legal Service code 29 | — | $234K |
| PSG CONSULTING, LLC EIN 27-2345574 NONE | Consulting (general) Service code 16 | — | $189K |
| CHICAGO AND MIDWEST REGIONAL JT BD EIN 36-2938055 PARTY-IN-INT | Other services; Plan Administrator Service code 14 | — | $145K |
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing; Float revenue Service code 12 | — | $106K |
| SOUTHERN REGIONAL JOINT BOARD WORKE EIN 58-1086875 PARTY-IN-INT | Plan Administrator Service code 14 | — | $96K |
| WESTERN STATES REGIONAL JOINT BOARD EIN 95-0488945 PARTY-IN-INT | Plan Administrator Service code 14 | — | $90K |
| NEW ENGLAND JOINT BOARD-UNITE HERE EIN 04-3440556 PARTY-IN-INT | Plan Administrator Service code 14 | — | $89K |
| WORKERS UNITED EIN 26-4459382 PARTY-IN-INT | Plan Administrator Service code 14 | — | $84K |
| SOUTHWEST REGIONAL JOINT BOARD WORK EIN 43-0822854 PARTY-IN-INT | Plan Administrator Service code 14 | — | $84K |
| BDO USA, LLP. EIN 13-5381590 NONE | Accounting (including auditing) Service code 10 | — | $76K |
| NEW YORK METROPOLITAN AREA JOINT BO EIN 20-0354131 PARTY-IN-INT | Plan Administrator Service code 14 | — | $73K |
| AMALGAMATED BANK EIN 13-4920330 OWNED BY PARTY-IN-INT | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Custodial (securities) Service code 19 | — | $66K |
| PARAMETRIC PORTFOLIO ASSOCIATES, LL EIN 20-0292745 NONE | Investment management fees paid directly by plan Service code 51 | — | $60K |
| PENNSYLVANIA JOINT BOARD EIN 23-2929642 PARTY-IN-INT | Plan Administrator Service code 14 | — | $60K |
| DELTA DENTAL OF NEW YORK EIN 11-1980218 NONE | Claims processing Service code 12 | — | $59K |
| UNION BENEFIT CONSULTING EIN 46-1967993 NONE | Consulting (general) Service code 16 | — | $49K |
| CYNOMYS, INC. EIN 22-3007300 NONE | Actuarial Service code 11 | — | $45K |
| BOGDAHN GROUP EIN 59-3676225 NONE | Investment management fees paid directly by plan Service code 51 | — | $45K |
| JOHNSTON ASSET MANAGEMENT MANAGEMEN EIN 13-3257590 NONE | Investment management fees paid directly by plan Service code 51 | — | $37K |
| MID-ATLANTIC REGIONAL JOINT BOARD EIN 52-1367543 PARTY-IN-INT | Plan Administrator Service code 14 | — | $30K |
| SS&C TECHNOLOGIES | Investment management fees paid indirectly by plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $26K |
| CONVEY COMPLIANCE SERVICE, INC. EIN 47-1073810 NONE | Other services Service code 49 | — | $19K |
| WEDGE CAPITAL MANAGEMENT EIN 56-1557450 NONE | Soft dollars commissions; Investment management fees paid directly by plan Service code 51 | — | $19K |
| CRYSTAL IBC, LLC | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $19K |
| SEIU LOCAL 49 EIN 93-0131365 PARTY-IN-INT | Other services Service code 49 | — | $10K |
| WILSON, ELSER, MOSKOWITZ, ELDELAN&D EIN 13-2679447 NONE | Legal Service code 29 | — | $8K |
| AAA MINI-SAN JUAN NONE | Other services Service code 49 | PO BOX 281 GIRARD, OH 44420 | $8K |
| WORLDLINK EIN 04-3090158 NONE | Other services Service code 49 | — | $7K |
| PHILADELPHIA JOINT BOARD-WORKERS UN EIN 23-0971735 PARTY-IN-INT | Plan Administrator Service code 14 | — | $7K |
| CRYSTAL IBC, LLC. EIN 47-2002720 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $0 |
| SSC TECHNOLOGIES EIN 06-1169696 NONE | Investment management fees paid indirectly by plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $0 |
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 | 23,986 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25,653 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 49,639 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | HEALTH PLAN OF NEVADA | 1,441 | $6.1M |
| Dental(7 contracts, 5 carriers) | DELTA DENTAL OF NEW YORK | 469 | $227K |
| Vision | VISION SERVICE PLAN | 310 | $63K |
| Life insurance | THE AMALGAMATED LIFE INSURANCE COMPANY | 30,875 | $1.6M |
| Short-term disability | THE AMALGAMATED LIFE INSURANCE COMPANY | 23,986 | $1.4M |
| Prescription drug(2 contracts, 2 carriers) | HEALTH PLAN OF NEVADA | 1,441 | $4.9M |
| Other | TRIPLE-S, INC. | 2 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 30,875 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.