| 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 | $99K | — | $99K | 2.25% |
| KORNER & DE GRAFF BENEFITS0 | AND CONSULTING, LLC 3025 OXFORD LANE NORTHBROOK, IL 600626423 | BLUE CROSS BLUE SHEILD OF ILLINOIS | $15K | — | $15K | 0.76% |
| CARLOS DONALD REYNOSO3 | 3123 VILLA COLINA SPRING VALLEY, CA 91978 | HEALTH NET | $21K | — | $21K | 3.63% |
| CARLOS REYNOSO3 Filed as: CARLOS MONTERO REYNOSO | 1337 PASEO SERNO SAN DIMAS, CA 91773 | HEALTH NET | $7K | — | $7K | 1.21% |
| FRANKIE DIAZ OTERO0 | RR4 BOX 3414 BAYAMON, PR 00956 | MCS LIFE INSURANCE COMPANY | $5K | $0 | $5K | 3.45% |
| MYRIAD BENEFITS INC3 Filed as: MYRIAD BENEFITS | PO BOX 1377 GUAYNABO, PR 00970 | MCS LIFE INSURANCE COMPANY | $4K | — | $4K | 2.49% |
| FRANKIE DIAZ OTERO3 | RR4 BOX 3414 BAYAMON, PR 00956 | DELTA DENTAL OF PUERTO RICO, INC | $878 | $0 | $878 | 9.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALICARE EIN 13-3432221 OWNED BY PARTY-IN-INTERES | Direct payment from the plan; Contract Administrator Service code 13 | — | $25.4M |
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Claims processing; Contract Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services Service code 12 | — | $4.1M |
| ANTHEM BLUE CROSS BLUE SHIELD NONE | Claims processing; Direct payment from the plan Service code 12 | 43612 IRWIN SIMPSON ROAD MASON, OH 45040 | $4.0M |
| ALICARE INC. (CC) EIN 13-3432221 OWNED BY PARTY-IN-INTERES | Direct payment from the plan; Other services Service code 49 | — | $3.6M |
| ALICARE MEDICAL MANAGEMENT, INC EIN 13-3860528 OWNED BY PARTY-IN-INTERES | Direct payment from the plan; Other services Service code 49 | — | $2.8M |
| BLUE CROSS BLUE SHIELD OF MASSACHUS EIN 04-1045815 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $2.0M |
| SIDNEY HILLMAN HEALTH CENTER EIN 36-2245908 PARTY-IN-INTEREST | Direct payment from the plan; Claims processing Service code 12 | — | $348K |
| NEW YORK NEW JERSEY REGIONAL JT BD EIN 13-4908365 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $271K |
| SCHULTE ROTH & ZABEL LLP EIN 13-2633996 NONE | Legal; Direct payment from the plan Service code 29 | — | $195K |
| PSG CONSULTING, LLC. EIN 27-2345574 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $129K |
| SOUTHERN REGIONAL JOINT BOARD WORKE EIN 58-1086875 PARTY-IN-INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $129K |
| CHICAGO AND MIDWEST REGIONAL JT BD EIN 36-2938055 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan; Other services Service code 14 | — | $123K |
| NEW ENGLAND JOINT BOARD-UNITE HERE EIN 04-3440556 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $115K |
| ALIGRAPHICS, A DIVISION OF ALICARE, EIN 13-3432221 OWNED BY PARTY-IN-INTERES | Other services; Direct payment from the plan Service code 49 | — | $102K |
| CVS EIN 05-0340626 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $89K |
| BDO USA, LLP. EIN 13-5381590 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $82K |
| SOUTHWEST REGIONAL JOINT BOARD EIN 43-0822854 PARTY-IN-INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $81K |
| WORKERS UNITED EIN 26-4459382 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $72K |
| AMALGAMATED BANK EIN 13-4920330 OWNED BY PARTY-IN-INTERES | Custodial (securities); Investment management fees paid indirectly by plan; Investment management fees paid directly by plan Service code 19 | — | $63K |
| NEW YORK METROPOLITAN JOINT BOARD EIN 20-0354131 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $63K |
| ANDCO CONSULTING, LLC EIN 59-3676225 NONE | Investment management fees paid directly by plan Service code 51 | — | $60K |
| PENNSYLVANIA JOINT BOARD EIN 23-2929642 PARTY-IN-INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $52K |
| UNION BENEFIT CONSULTING EIN 46-1967993 NONE | Consulting (general) Service code 16 | — | $50K |
| WESTERN STATES REGIONAL JOINT BOARD EIN 95-0488945 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $48K |
| CYNOMYS, INC. EIN 82-2668930 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $47K |
| UNITE HERE HEALTH CENTER EIN 13-5563408 PARTY-IN-INTEREST | Direct payment from the plan; Other services; Contract Administrator Service code 13 | — | $47K |
| SOVOS COMPLIANCE, LLC EIN 46-1379693 NONE | Other services Service code 49 | — | $39K |
| JOHNSTON ASSET MANAGEMENT EIN 13-3257590 NONE | Investment management fees paid directly by plan Service code 51 | — | $39K |
| DELTA DENTAL OF NEW YORK EIN 11-1980218 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $34K |
| MID-ATLANTIC REGIONAL JOINT BOARD EIN 52-1367543 PARTY-IN-INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $26K |
| SS&C TECHNOLOGIES | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $24K |
| CRYSTAL IBC, LLC | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $19K |
| WEDGE CAPITAL MANAGEMENT EIN 56-1557450 NONE | Investment management fees paid directly by plan; Soft dollars commissions Service code 51 | — | $18K |
| WORLDLINK EIN 04-3009015 NONE | Other services Service code 49 | — | $15K |
| PHILADELPHIA JOINT BOARD-WORKERS UN EIN 23-0971735 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $13K |
| PARAMETRIC PORTFOLIO ASSOCIATES, LL EIN 20-0292745 NONE | Investment management fees paid directly by plan Service code 51 | — | $11K |
| SEIU LOCAL 49 EIN 93-0131365 PARTY-IN-INTEREST | Direct payment from the plan; Other services Service code 49 | — | $10K |
| AMALGAMATED LIFE INSURANCE COMPANY EIN 13-5501223 OWNED BY PARTY-IN-INTERES | Other services; Direct payment from the plan Service code 49 | — | $8K |
| AAA MINI-SAN JUAN NONE | Other services; Direct payment from the plan Service code 49 | PO BOX 281 GIRARD, OH 44420 | $8K |
| CRYSTAL IBC, LLC. EIN 47-2002720 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $0 |
| SSC TECHNOLOGIES EIN 06-1169696 NONE | 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 | 22,225 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22,246 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 44,471 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | HEALTH PLAN OF NEVADA | 1,137 | $5.6M |
| Dental(7 contracts, 5 carriers) | DELTA DENTAL OF NEW YORK | 383 | $182K |
| Vision | VISION SERVICE PLAN | 363 | $58K |
| Life insurance(4 contracts) | THE AMALGAMATED LIFE INSURANCE COMPANY | 28,160 | $2.8M |
| Short-term disability | THE AMALGAMATED LIFE INSURANCE COMPANY | 22,225 | $1.7M |
| Prescription drug(2 contracts, 2 carriers) | HEALTH PLAN OF NEVADA | 1,137 | $4.4M |
| Other | TRIPLE-S, INC. | 2 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 28,160 | — |
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.