| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AFS AGENCY3 | 185 GENESEE STREET 2ND FL ADIRONDACK BANK BLDG UTICA, NY 13501 | EXCELLUS BLUECROSS BLUESHIELD | $34K | — | $34K | 3.89% |
| ROGER BOUCHARD INSURANCE INC3 | 5310 CLARK RD STE 1 SARASOTA, FL 34233 | UNITEDHEALTHCARE INSURANCE COMPANY | $20K | — | $20K | 5.60% |
| BOND BENEFITS CONSULTING LLC3 Filed as: BOND FINANCIAL NETWORK | 71A MONROE AVENUE PITTSFORD, NY 14534 | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $6K | — | $6K | 9.02% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: GILROY KERNAN & GILROY INC. | 210 CLINTON STREET NEW HARTFORD, NY 13413 | GUARDIAN | $2K | — | $2K | 4.81% |
| ALLIANCE ADVISORY GRP INC3 | 350 ESSJAY ROAD WILLIAMSVILLE, NY 14221 | GUARDIAN | $46 | — | $46 | 0.10% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 19.22% |
| AFS AGENCY3 | 185 GENESEE ST SUITE 210 UTICA, NY 13501 | HM LIFE INSURANCE COMPANY OF NEW YORK | $1K | — | $1K | 10.00% |
| BOND BENEFITS CONSULTING LLC3 Filed as: BOND FINANCIAL NETWORK | 71A MONROE AVENUE PITTSFORD, NY 14534 | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $911 | — | $911 | 15.01% |
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 | 242 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EXCELLUS BLUECROSS BLUESHIELD | 106 | $1.2M |
| Dental(2 contracts, 2 carriers) | GUARDIAN | 88 | $50K |
| Vision(2 contracts, 2 carriers) | HM LIFE INSURANCE COMPANY OF NEW YORK | 75 | $11K |
| Life insurance(4 contracts, 2 carriers) | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 156 | $123K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 61 | $19K |
| Long-term disability(2 contracts, 2 carriers) | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 156 | $98K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 106 | $870K |
| Other(3 contracts, 2 carriers) | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 156 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.