| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM LACOUNT | 2 CRIMSON WAY PLATTSBURGH, NY 12901 | COLUMBIAN MUTUAL LIFE INSURANCE CO. | $0 | $334 | $334 | 2.41% |
| DAVID JENKINS3 | 76 PRISON RD CADYVILLE, NY 12918 | FIRST UNUM LIFE INSURANCE CO | $178 | — | $178 | 3.77% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM LACOUNT | 2 CRIMSON WAY PLATTSBURGH, NY 12901 | FIRST UNUM LIFE INSURANCE CO | $157 | — | $157 | 3.32% |
| GEORGE BEARUP3 | 519 W. MULLIN ST WATERTOWN, NY 13601 | FIRST UNUM LIFE INSURANCE CO | $63 | — | $63 | 1.33% |
| NORTHERN INSURING AGENCY INC.3 Filed as: NORTHERN INSURING AGENCY INC | 171 MARGARET ST PLATTSBURGH, NY 12901 | FIRST UNUM LIFE INSURANCE CO | $46 | — | $46 | 0.97% |
| RICHARD BROGOWSKI3 | 1 LEWIS COURT PLATTSBURGH, NY 12901 | FIRST UNUM LIFE INSURANCE CO | $24 | — | $24 | 0.51% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM LACOUNT | 76 TRUDEAU ROAD CADYVILLE, NY 12918 | AFLAC | $45 | — | $45 | 7.91% |
| DAVID JENKINS3 | 76 TRUDEAU ROAD CADYVILLE, NY 12918 | AFLAC | $35 | — | $35 | 6.15% |
| LOUIS FAIOLA3 | 12 HAAWK COURT DELMAR, NY 12054 | AFLAC | $18 | — | $18 | 3.16% |
| MELVIN R JONES3 Filed as: MELVIN JONES | 3025 ELIOCH MANOR DRIVE POWHATAN, VA 23139 | AFLAC | $5 | — | $5 | 0.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BONADIO & CO., LLP EIN 16-1131146 ACCOUNTANT | Accounting (including auditing) Service code 10 | 6 WEMBLEY COURT ALBANY, NY 12205 | $13K |
| EASTERN TECHNICAL SERVICES INC EIN 14-1656330 EMPLOYEE | Employee (plan) Service code 30 | 186 US OVAL PLATTSBURGH, NY 12903 | $11K |
| PINNACLE PROPERTIES, LLC EIN 06-1766357 LANDLORD | Other fees Service code 99 | PO BOX 983 PLATTSBURGH, NY 12901 | $5K |
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 | 2,722 | 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) | 2,722 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COLUMBIAN MUTUAL LIFE INSURANCE CO. | 18 | $14K |
| Short-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE CO | 9 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 18 | — |
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.