| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: BOUCHEY & CLARKE BENEFITS, INC | PO BOX 1616 TROY, NY 12181 | BLUE SHIELD OF NORTHEASTERN NEW YORK | $21K | — | $21K | 4.19% |
| ENROLLEASE3 Filed as: BOUCHEY & CLARKE BENEFITS INC | PO BOX 1616 TROY, NY 12181 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | — | $2K | 9.02% |
| ENROLLEASE3 Filed as: BOUCHEY & CLARKE BENEFITS INC | PO BOX 1616 TROY, NY 12181 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $1K | — | $1K | 11.34% |
| ENROLLEASE3 Filed as: BOUCHEY & CLARKE BENEFITS INC | PO BOX 1616 TROY, NY 12181 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | — | $2K | 15.00% |
| ENROLLEASE3 Filed as: BOUCHEY & CLARK BENEFITS INC | PO BOX 1616 TROY, NY 12181 | DELTA DENTAL OF NEW YORK | $868 | — | $868 | 11.66% |
| ENROLLEASE3 Filed as: BOUCHEY & CLARKE BENEFITS INC | 1819 FIFTH AVENUE TROY, NY 12180 | HM LIFE INSURANCE CO OF NY | $693 | — | $693 | 10.01% |
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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF NORTHEASTERN NEW YORK | 86 | $503K |
| Dental | DELTA DENTAL OF NEW YORK | 144 | $7K |
| Vision | HM LIFE INSURANCE CO OF NY | 63 | $7K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 151 | $12K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 153 | $25K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 151 | $12K |
| Prescription drug | BLUE SHIELD OF NORTHEASTERN NEW YORK | 86 | $503K |
| Other | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 151 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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.