No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK BLUECROSS BLUESHIELD OF WN EIN 16-1105741 CONTRACT ADMIN | Contract Administrator; Direct payment from the plan Service code 13 | — | $97K |
| TOWERS WATSON INVESTMENT SERVICES EIN 52-1868818 CONSULTANT | Consulting (general); Direct payment from the plan Service code 16 | — | $10K |
| CVS CAREMARK EIN 05-0340626 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | — | $7K |
| BLACKROCK INSTITUTIONAL TRUST COMP EIN 94-3112180 INVESTMENT MANAGER | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Investment management; Investment management fees paid directly by plan; Trustee (discretionary) Service code 21 | — | $4K |
| JPMORGAN CHASE BANK, N.A. EIN 13-4994650 TRUSTEE | Other investment fees and expenses; Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Float revenue Service code 21 | — | $2K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 191 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 2 carriers) | HIGHMARK BLUECROSS BLUESHIELD OF WNY | 56 | $182K |
| Dental | HIGHMARK BLUECROSS BLUESHIELD OF WNY | 2 | $12K |
| Vision | HIGHMARK BLUECROSS BLUESHIELD OF WNY | 2 | $12K |
| Life insurance | PRUDENTIAL LIFE INSURANCE CO | 190 | $73K |
| Prescription drug | HIGHMARK BLUECROSS BLUESHIELD OF WNY | 2 | $12K |
| Stop-loss / reinsurancereinsurance | HIGHMARK BLUECROSS BLUESHIELD OF WNY | 2 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.