| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN BENEFITS GROUP, INC.3 | 2914 PINE AVENUE NIAGARA FALLS, NY 14301 | HIGHMARK NEW YORK | $46K | — | $46K | 12.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ERNST & YOUNG LLP NONE | Accounting (including auditing); Direct payment from the plan; Consulting (general) Service code 10 | ONE MANHATTAN WEST 395 9TH AVENUE NEW YORK, NY 10001 | $101K |
| EXPRESS SCRIPTS NONE | Direct payment from the plan; Claims processing Service code 12 | 1 EXPRESS WAY ST. LOUIS, MO 63121 | $99K |
| PROFESSIONAL BENEFIT ADMINISTRATORS NONE | Direct payment from the plan; Claims processing Service code 12 | P.O. BOX 4687 OAK BROOK, IL 60522 | $15K |
| UNITEDHEALTHCARE INSURANCE COMPANY EIN 36-2739571 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $13K |
| RUBINBROWN LLP EIN 43-0765316 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $12K |
| THE SEGAL GROUP, INC. EIN 13-1835864 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $11K |
| PRINCIPAL CUSTODY SOLUTIONS PARTY-IN-INTEREST | Custodial (other than securities); Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 18 | 510 N. VALLEY MILLS DRIVE SUITE 400 WACO, TX 767106075 | $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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 121 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HIGHMARK NEW YORK | 75 | $424K |
| Prescription drug | HIGHMARK NEW YORK | 75 | $382K |
| Other | ANTHEM HEALTH PLANS, INC. | 1 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 75 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.