| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONDSCHEIN ASSOCIATES, INC.3 Filed as: MONDSCHEIN ASSOCIATES INC. | 450 N END AVE 19A NEW YORK, NY 10282 | ANTHEM BLUE CROSS AND BLUE SHIELD | $12K | $0 | $12K | 10.21% |
| MONDSCHEIN ASSOCIATES, INC.3 | 450 N END AVE 19A NEW YORK, NY 10282 | ANTHEM BLUE CROSS AND BLUE SHIELD | $10K | $0 | $10K | 9.82% |
| MONDSCHEIN ASSOCIATES, INC.3 Filed as: MONDSCHEIN ASSOCIATES INC | 450 N END AVE 19A NEW YORK, NY 10282 | STANDARD INSURANCE COMPANY | $9K | $0 | $9K | 10.91% |
| JOSHUA MONDSCHEIN3 | 1123 BROADWAY STE 1116 NEW YORK, NY 100102156 | KAISER PERMANENTE | $665 | $0 | $665 | 4.96% |
| JOSHUA MONDSCHEIN3 | 450 N END AVE APT 19A NEW YORK, NY 10010 | HEALTH NET | $652 | $0 | $652 | 4.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS EIN 23-7391136 ADMIN | Float revenue; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $133K |
| MONDSCHEIN ASSOCIATES INC. | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $84K |
| EMPIRE HEALTHCHOICE ASSURANCE, INC. | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue Service code 12 | — | $58K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $23K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $8K |
| EMPIRE HEALTHCHOICE ASSURANCE EIN 23-7391136 ADMIN | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $0 |
| MONDSCHEIN ASSOCIATES INC BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 1123 BROADWAY, STE 1116 NEW YORK, NY 10010 | $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 | 149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER PERMANENTE | 5 | $30K |
| Dental(2 contracts, 2 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD | 203 | $127K |
| Vision(2 contracts, 2 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD | 203 | $127K |
| Life insurance(3 contracts, 2 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD | 203 | $295K |
| Short-term disability(3 contracts, 2 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD | 203 | $295K |
| Long-term disability(3 contracts, 2 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD | 203 | $295K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 0 | $4K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HM LIFE INSURANCE COMPANY | 203 | $579K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.