Form 5500 · Employee benefit plan · MELVILLE, NY
QUONTIC BANK
The filing calls this plan QUONTIC BANK EMPLOYEE BENEFITS PROGRAM.
QUONTIC BANK of MELVILLE, NY insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is GARY WOOD ASSOCIATES. Coverage is written through EMPIRE HEALTHCHOICE ASSURANCE, INC. and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-2097129 · plan 501 · plan year 2024, filed Oct 2, 2025
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 4 insured contracts covering health, dental, vision, life and disability; the largest, with EMPIRE HEALTHCHOICE ASSURANCE, INC., covers 266 people.
Reported premium across the insured contracts is $2,107,908, with $135,705 in disclosed broker commissions — about 6.4% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in April. The plan is on a split renewal cycle.
GARY WOOD ASSOCIATES is the broker of record on all 4 contracts.
3 carriers appear on the filing, including EMPIRE HEALTHCHOICE ASSURANCE, INC., SUN LIFE AND HEALTH INSURANCE COMPANY and EYEMED VISION CARE. EMPIRE HEALTHCHOICE ASSURANCE, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. | Health, Dental | 266 | Jan 1, 2025 | $1,999,237 | $117,711 |
| SUN LIFE AND HEALTH INSURANCE COMPANY | Life, Disability | 173 | May 1, 2024 | $77,489 | $13,330 |
| EYEMED VISION CARE | Vision | 200 | May 1, 2024 | $19,351 | $2,957 |
| EYEMED VISION CARE | Vision | 212 | Jan 1, 2025 | $11,831 | $1,707 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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