| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN, INC. | 99 TROY ROAD P.O. BOX 640 EAST GREENBUSH, NY 12061 | MVP HEALTH CARE | $43K | — | $43K | 3.26% |
| AMA BROKERS, INC.3 | P.O. BOX 5004 11 GAY LANE EAST HAMPTON, NY 11937 | OXFORD HEALTH PLANS | $14K | — | $14K | 3.24% |
| EMERSON REID LLC3 Filed as: EMERSON REID & COMPANY, INC. | 669 RIVER DRIVE CENTER II SUITE 305 ELMWOOD PARK, NJ 07407 | OXFORD HEALTH PLANS | — | $4K | $4K | 1.00% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203066 NEW JERSEY LOCKBOX DALLAS, TX 75320 | CIGNA LIFE INS. CO. OF NY | $3K | — | $3K | 5.86% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 823237 PENNSYLVANIA LOCK BOX PHILADELPHIA, PA 19182 | CIGNA LIFE INS. CO. OF NY | $2K | $474 | $2K | 5.15% |
| BOND BENEFITS CONSULTING LLC3 Filed as: BOND FINANCIAL NETWORK, INC. | 71A MONROE AVENUE PITTSFORD VILLAGE GREEN PITTSFORD, NY 14534 | CIGNA LIFE INS. CO. OF NY | $4K | — | $4K | 9.77% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KEIRNAN, INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | EXCELLUS BLUE CROSS BLUE SHIELD ROCHESTER | $3K | — | $3K | 11.61% |
| BOND BENEFITS CONSULTING LLC3 Filed as: BOND FINANCIAL NETWORK, INC. | 71A MONROE AVENUE PITTSFORD VILLAGE GREEN PITTSFORD, NY 14534 | CIGNA LIFE INS. CO. OF NY | $601 | — | $601 | 14.99% |
No Schedule C service providers reported on this filing.
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 | 242 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MVP HEALTH CARE | 192 | $1.8M |
| Dental | EXCELLUS BLUE CROSS BLUE SHIELD ROCHESTER | 44 | $26K |
| Life insurance | CIGNA LIFE INS. CO. OF NY | 246 | $47K |
| Long-term disability | CIGNA LIFE INS. CO. OF NY | 246 | $42K |
| Other(2 contracts) | CIGNA LIFE INS. CO. OF NY | 246 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 246 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.