| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE MARY IMOGENE BASSETT HOSPITAL | 1 ATWELL ROAD COOPERSTOWN, NY 13326 | EXCELLUS BLUE CROSS BLUE SHIELD | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | 12 RHOADS DRIVE UTICA, NY 13502 | $1.4M |
| LIFETIME BENEFIT SOLUTIONS EIN 16-1171765 TPA | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 115 CONTINUUM DRIVE LIVERPOOL, NY 13088 | $117K |
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 | 3,650 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 338 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 25 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 4,013 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUE CROSS BLUE SHIELD | 2,594 | $694K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,594 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.