| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 | 7789 OSWEGO RD LIVERPOOL, NY 13090 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | — | $1K | 0.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 NONE | Claims processing Service code 12 | 165 COURT STREET ROCHESTER, NY 14647 | $263K |
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 | 592 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 602 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP OF NEW YORK | 904 | $225K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP OF NEW YORK | 904 | $271K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 592 | $159K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 592 | $249K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 592 | $249K |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUE CROSS BLUE SHIELD | 353 | $417K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 592 | $249K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 904 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.