| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN BENEFITS GROUP, INC.3 | 2914 PINE AVENUE NIAGARA FALLS, NY 14301 | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $8K | — | $8K | 3.21% |
| PROFESSIONAL BENEFIT ADMIN3 Filed as: PROFESSIONAL BENEFIT ADMIN. | 900 JORIE BLVD., #250 OAK BROOK, IL 60523 | UNIMERICA INSURANCE COMPANY | $25K | — | $25K | 16.35% |
| HOLLIS D SEGUR INC3 Filed as: HOLLIS D. SEGUR INC. | P.O. BOX 400 CHESHIRE, CT 06410 | ANTHEM HEALTH PLANS, INC. | $235 | — | $235 | 2.13% |
| HOLLIS D SEGUR INC3 Filed as: HOLLIS D. SEGUR INC. | P.O. BOX 631 WATERBURY, CT 06720 | ANTHEM HEALTH PLANS, INC. | $15 | — | $15 | 0.14% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 241 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 52 | $337K |
| Prescription drug | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 52 | $240K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 65 | $150K |
| Other | ANTHEM HEALTH PLANS, INC. | 3 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 65 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.