| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE CAPITAL REGION STRATEGIC EBS LL3 Filed as: CAPITAL REGION STRATEGIC EBS | 1201 TROY SCHENECTADY ROAD SUITE 120 LATHAM, NY 12110 | HEALTHNOW NEW YORK INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $18K | — | $18K | 1.86% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 6 TOWER PLACE ALBANY, NY 12203 | HEALTHNOW NEW YORK INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $18K | — | $18K | 1.84% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 6 TOWER PLACE ALBANY, NY 12203 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $685 | $5K | 3.99% |
| THE CAPITAL REGION STRATEGIC EBS LL3 Filed as: THE CAPITAL REGION STRATEGIC EBS | 1201 TROY SCHENECTADY RD STE 120 LATHAM, NY 12110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.03% |
| THE CAPITAL REGION STRATEGIC EBS LL3 Filed as: CAPITAL REGION STRATEGIC EBS | 1201 TROY SCHENECTADY STE 120 LATHAM, NY 12110 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 5.10% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 6 TOWER PLACE ALBANY, NY 12203 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 4.90% |
| ENROLLEASE3 Filed as: JAEGER & FLYNN ASSOCIATES INC | 30 CORPORATE DR CLIFTON PARK, NY 12065 | THE PAUL REVERE LIFE INSURANCE COMPANY | $321 | — | $321 | 10.75% |
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 | 220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHNOW NEW YORK INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 220 | $987K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 187 | $130K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 187 | $130K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 187 | $130K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 49 | $42K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 49 | $42K |
| Other | THE PAUL REVERE LIFE INSURANCE COMPANY | 6 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.