| 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 | $92K | — | $92K | 2.06% |
| CARLOS DONALD REYNOSO3 | 3123 VILLA COLINA SPRING VALLEY, CA 91978 | HEALTH NET | $25K | — | $25K | 3.91% |
| CARLOS REYNOSO3 Filed as: CARLOS MONTERO REYNOSO | 1337 PASEO SERNO SAN DIMAS, CA 91773 | HEALTH NET | $8K | — | $8K | 1.30% |
| FRANKIE DIAZ OTERO3 | RR 4 BOX 3414 BAYAMON, PR 00956 | MCS LIFE INSURANCE COMPANY | $10K | — | $10K | 5.78% |
| FRANKIE DIAZ OTERO3 | RR4 BOX 3414 BAYAMON, PR 00956 | DELTA DENTAL OF PUERTO RICO, INC | $948 | — | $948 | 9.00% |
| CARLOS REYNOSO3 | 1337 PASEO SERENO SAN DIMAS, CA 917734140 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | — | $2K | 25.55% |
| CARLOS REYNOSO3 | 3123 VILLA COLINA SPRING VALLEY, CA 919781123 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | — | $2K | 25.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALICARE EIN 13-3432221 OWNED BY PARTY-IN-INTERES | Contract Administrator; Direct payment from the plan Service code 13 | — | $26.0M |
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Float revenue; Other services; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $4.1M |
| ANTHEM BLUE CROSS BLUE SHIELD NONE | Direct payment from the plan; Claims processing Service code 12 | 43612 IRWIN SIMPSON ROAD MASON, OH 45040 | $3.9M |
| ALICARE INC. (CC) EIN 13-3432221 OWNED BY PARTY-IN-INTERES | Other services; Direct payment from the plan Service code 49 | — | $3.6M |
| ALICARE MEDICAL MANAGEMENT, INC EIN 13-3860528 OWNED BY PARTY-IN-INTERES | Other services; Direct payment from the plan Service code 49 | — | $2.3M |
| 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 | Claims processing; Direct payment from the plan Service code 12 | — | $330K |
| NEW YORK NEW JERSEY REGIONAL JT BD EIN 13-4908365 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $249K |
| ALIGRAPHICS, A DIVISION OF ALICARE, EIN 13-3432221 OWNED BY PARTY-IN-INTERES | Other services; Direct payment from the plan Service code 49 | — | $158K |
| NEW ENGLAND JOINT BOARD-UNITE HERE EIN 04-3440556 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $147K |
| SOUTHERN REGIONAL JOINT BOARD WORKE EIN 58-1086875 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $131K |
| PSG CONSULTING, LLC. EIN 27-2345574 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $126K |
| CHICAGO AND MIDWEST REGIONAL JT BD EIN 36-2938055 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan; Other services Service code 14 | — | $108K |
| BDO USA, LLP. EIN 13-5381590 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $94K |
| SCHULTE ROTH & ZABEL LLP EIN 13-2633996 NONE | Legal; Direct payment from the plan Service code 29 | — | $82K |
| ANDCO CONSULTING, LLC EIN 59-3676225 NONE | Investment management fees paid directly by plan Service code 51 | — | $75K |
| SOUTHWEST REGIONAL JOINT BOARD EIN 43-0822854 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $62K |
| NEW YORK METROPOLITAN JOINT BOARD EIN 20-0354131 PARTY-IN-INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $55K |
| PENNSYLVANIA JOINT BOARD EIN 23-2929642 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $53K |
| AMALGAMATED BANK EIN 13-4920330 OWNED BY PARTY-IN-INTERES | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Custodial (securities) Service code 19 | — | $47K |
| CYNOMYS, INC. EIN 82-2668930 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $46K |
| JOHNSTON ASSET MANAGEMENT EIN 13-3257590 NONE | Investment management fees paid directly by plan Service code 51 | — | $45K |
| UNITE HERE HEALTH CENTER EIN 13-5563408 PARTY-IN-INTEREST | Other services; Direct payment from the plan; Contract Administrator Service code 13 | — | $42K |
| WESTERN STATES REGIONAL JOINT BOARD EIN 95-0488945 PARTY-IN-INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $38K |
| AMALGAMATED LIFE INSURANCE COMPANY EIN 13-5501223 OWNED BY PARTY-IN-INTERES | Other services; Direct payment from the plan Service code 49 | — | $35K |
| DELTA DENTAL OF NEW YORK EIN 11-1980218 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $32K |
| UNION BENEFIT CONSULTING EIN 46-1967993 NONE | Consulting (general) Service code 16 | — | $29K |
| SS&C TECHNOLOGIES | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $28K |
| PARAMETRIC PORTFOLIO ASSOCIATES, LL EIN 20-0292745 NONE | Investment management fees paid directly by plan Service code 51 | — | $23K |
| CVS EIN 05-0340626 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $19K |
| WORKERS UNITED EIN 26-4459382 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $17K |
| WEDGE CAPITAL MANAGEMENT EIN 56-1557450 NONE | Soft dollars commissions; Investment management fees paid directly by plan Service code 51 | — | $15K |
| CRYSTAL IBC, LLC | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $12K |
| PHILADELPHIA JOINT BOARD-WORKERS UN EIN 23-0971735 PARTY-IN-INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $11K |
| MID-ATLANTIC REGIONAL JOINT BOARD EIN 52-1367543 PARTY-IN-INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $10K |
| SEIU LOCAL 49 EIN 93-0131365 PARTY-IN-INTEREST | Direct payment from the plan; Other services Service code 49 | — | $10K |
| AAA MINI-SAN JUAN NONE | Direct payment from the plan; Other services Service code 49 | PO BOX 281 GIRARD, OH 44420 | $8K |
| SOVOS COMPLIANCE, LLC EIN 46-1379693 NONE | Other services Service code 49 | — | $7K |
| 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 | 22,808 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19,642 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 42,450 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | HEALTH PLAN OF NEVADA | 1,230 | $5.3M |
| Dental(7 contracts, 5 carriers) | DELTA DENTAL OF NEW YORK | 393 | $186K |
| Vision | VISION SERVICE PLAN | 426 | $53K |
| Life insurance(3 contracts) | THE AMALGAMATED LIFE INSURANCE COMPANY | 28,193 | $2.7M |
| Short-term disability | THE AMALGAMATED LIFE INSURANCE COMPANY | 22,808 | $1.6M |
| Prescription drug(2 contracts, 2 carriers) | HEALTH PLAN OF NEVADA | 1,230 | $4.5M |
| Other | TRIPLE-S, INC. | 2 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 28,193 | — |
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.