No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DICKINSON GROUP LLC EIN 20-1241472 TPA | Actuarial; Contract Administrator Service code 11 | 50 CHARLES LINDBERGH BLVD UNIONDALE, NY 11553 | $231K |
| EMPIRE HEALTHCHOICE ASSURANCE IN EIN 23-7391136 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue; Other services Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $96K |
| COSTAROTHBORT LLC EIN 46-5286678 ACCOUNTANT | Accounting (including auditing) Service code 10 | 445 BROADHOLLOW ROAD MELVILLE, NY 11747 | $38K |
| ANDREW FAIR ESQ EIN 20-3322400 TRUSTEE | Trustee (individual) Service code 20 | 16 INTERLAKEN DR EASTCHESTER, NY 10709 | $22K |
| MCCARTHY & PREECE LLP EIN 84-3667887 LAWYER | Legal Service code 29 | 100 DANBURY RD RIDGEFIELD, CT 06877 | $12K |
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 | 476 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 476 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.