| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE COMPANY | 1 EMPIRE DRIVE RENSSELAER, NY 12144 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $77K | $0 | $77K | 10.69% |
| THE MARY IMOGENE BASSETT HOSPITAL | 1 ATWELL ROAD COOPERSTOWN, NY 13326 | EXCELLUS BLUECROSS BLUESHIELD | — | — | $0 | 0.00% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE AGENCY | 1 EMPIRE DRIVE RENSSELAER, NY 12144 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $7K | $0 | $7K | 1.41% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE AGENCY | 1 EMPIRE DRIVE RENSSELAER, NY 12144 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $49K | $0 | $49K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE CROSS EIN 15-0329043 TPA | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 12 RHOADS DRIVE UTICA, NY 13502 | $1.3M |
| LIFETIME BENFIT SOLUTIONS EIN 16-1171765 TPA | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | 115 CONTINUUM DRIVE LIVERPOOL, NY 13088 | $104K |
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 | 3,383 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 316 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,699 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 2,740 | $558K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 3,557 | $719K |
| Long-term disability(2 contracts) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 1,042 | $821K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,557 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.