| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN BENEFITS GROUP, INC.3 | 2914 PINE AVE. NIAGARA FALLS, NY 14301 | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUESHIELD OF WESTERN NY | $45K | — | $45K | 2.48% |
| HOLLIS D SEGUR INC3 Filed as: HOLLIS D. SEGUR INC. | P.O. BOX 400 CHESHIRE, CT 06410 | ANTHEM HEALTH PLANS, INC. | $509 | — | $509 | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SIBSON CONSULTING EIN 13-1835864 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $26K |
| WELLS FARGO BANK, N.A. NONE | Custodial (other than securities); Shareholder servicing fees; Other fees; Direct payment from the plan Service code 18 | 1248 O STREET MAC N8032-021 LINCOLN, NE 68508 | $8K |
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 | 5,346 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 509 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,855 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUESHIELD OF WESTERN NY | 360 | $2.0M |
| Dental(4 contracts, 4 carriers) | DELTA DENTAL INSURANCE COMPANY | 3,219 | $2.2M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 6,999 | $356K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 3,774 | $2.2M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,567 | $405K |
| Other | ANTHEM HEALTH PLANS, INC. | 5 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,999 | — |
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.
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.