| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HR BENEFIT ADVISORS3 | 74 BROWNS RACE SUITE 200 ROCHESTER, NY 14614 | SUN LIFE AND HEALTH INSURANCE COMPANY | $4K | — | $4K | 4.95% |
| UNITED BENEFITS ADVISORS INC3 Filed as: UNITED BENEFITS ADVISORS INC. | 10 WUNSHINE LANE RED LION, PA 17356 | SUN LIFE AND HEALTH INSURANCE COMPANY | $121 | — | $121 | 0.15% |
| HR BENEFIT ADVISORS3 | 74 BROWNS RACE SUITE 200 ROCHESTER, NY 14614 | SUN LIFE AND HEALTH INSURANCE COMPANY | $6K | — | $6K | 8.81% |
| UNITED BENEFITS ADVISORS INC3 Filed as: UNITED BENEFITS ADVISORS INC. | 10 WUNSHINE LANE RED LION, PA 17356 | SUN LIFE AND HEALTH INSURANCE COMPANY | $99 | — | $99 | 0.15% |
| HR BENEFIT ADVISORS3 Filed as: HR BENEFIT ADVISORS LTD | 208 MILL STREET SUITE 400 ROCHESTER, NY 14614 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 6.32% |
| HR BENEFIT ADVISORS3 | 74 BROWNS RACE SUITE 200 ROCHESTER, NY 14614 | GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 9.40% |
| HR BENEFIT ADVISORS3 Filed as: HR BENEFIT ADVISORS LTD | 208 MILL STREET SUITE 400 ROCHESTER, NY 14614 | HARTFORD LIFE INSURANCE O. | $123 | — | $123 | 16.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GUARDIAN LIFE INSURANCE COMPANY EIN 13-5123390 CLAIMS PROCESSING | Claims processing Service code 12 | — | $11K |
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 | 233 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENT HEALTH | 39 | $214K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY | 173 | $14K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE AND HEALTH INSURANCE COMPANY | 233 | $102K |
| Short-term disability(2 contracts) | SUN LIFE AND HEALTH INSURANCE COMPANY | 250 | $144K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY | 233 | $65K |
| Prescription drug | INDEPENDENT HEALTH | 39 | $214K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 248 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.