| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADIRONDACK TRUST COMPANY3 Filed as: ADIRONDACK TRUST CO. FINANCIAL SVCS | 31 CHURCH STREET, P.O. BOX 336 SARATOGA SPRINGS, NY 12866 | FIRST UNUM LIFE INSURANCE COMPANY | $16K | $0 | $16K | 1.88% |
| ADIRONDACK TRUST COMPANY3 Filed as: ADIRONDACK TRUST CO. FINANCIAL SERV | 31 CHURCH STREET, 4TH FLOOR P.O. BOX 336 SARATOGA SPRINGS, NY 12866 | FIRST UNUM LIFE INSURANCE COMPANY | $11K | — | $11K | 6.32% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL DISTRICT PHYSICIAN'S HEALTH EIN 14-1641028 CLAIMS ADMINISTRATION | Claims processing; Contract Administrator Service code 12 | 500 PATROON CREEK BLVD ALBANY, NY 17055 | $996K |
| DELTA DENTAL OF NEW YORK EIN 11-1980218 CLAIMS ADMINISTRATION | Claims processing; Contract Administrator Service code 12 | ONE DELTA DRIVE MECHANICSBURG, PA 17055 | $74K |
| ENVISION PHARMACEUTICAL SVCS. INC. EIN 05-0570786 CLAIMS ADMINISTRATION | Contract Administrator; Claims processing Service code 12 | 2181 E. AURORA ROAD, SUITE 201 TWINSBURG, OH 44087 | $44K |
| ABCO EIN 52-1468699 BROKER | Insurance agents and brokers Service code 22 | 2445 M STREET NW WASHINGTON, DC 20037 | $35K |
| AMSURE, A DIVISION OF ATCFSI EIN 14-1829030 BROKER, CONSULTANT | Insurance agents and brokers; Consulting (general) Service code 16 | 12 COMPUTER DRIVE WEST ALBANY, NY 12205 | $25K |
| ADIRONDACK TRUST INSURANCE AGENCY EIN 14-1829030 BROKER | Insurance agents and brokers Service code 22 | 31 CHURCH STREET P.O. BOX 336 SARATOGA SPRINGS, NY 12866 | $12K |
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 | 5,770 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 48 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,818 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | DAVIS VISION | 2,654 | $170K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 2,220 | $824K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 2,220 | $824K |
| Long-term disability(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 2,220 | $998K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,654 | — |
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.