| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTOPHER SZEM3 Filed as: CHRISTOPHER B SZEM | 188 E BERGEN PL #201 RED BANK, NJ 07701 | HEALTHNOW NEW YORK INC. DBA BLUE CROSS BLUE SHIELD OF WESTERN NY | $83K | — | $83K | 0.50% |
| DANCOLE ASSOCIATES3 | 257 E. RIDGEWOOD AVE., STE 305 RIDGEWOOD, NJ 07450 | HEALTHNOW NEW YORK INC. DBA BLUE CROSS BLUE SHIELD OF WESTERN NY | $63K | — | $63K | 0.38% |
| WEALTH PRESERVATION SOLUTIONS3 | 257 E RIDGEWOOD AVE #305 RIDGEWOOD, NJ 07450 | HEALTHNOW NEW YORK INC. DBA BLUE CROSS BLUE SHIELD OF WESTERN NY | $42K | — | $42K | 0.25% |
| CHRISTOPHER SZEM3 Filed as: CHRISTOPHER B SZEM | BENECEPT CONSULTANTS 188 EAST BERGEN PLACE RED BANK, NJ 07701 | EXCELLUS BLUECROSS BLUESHIELD | $129K | — | $129K | 0.96% |
| CHRISTOPHER SZEM3 Filed as: CHRISTOPHER B SZEM | — | HEALTHNOW NEW YORK, INC. DBA BLUECROSS | $13K | — | $13K | 4.55% |
| SYNADS INSURANCE AGENCY, INC3 | PO BOX 7347 ALBANY, NY 12204 | THE HARTFORD | $34K | — | $34K | 18.09% |
| CHRISTOPHER SZEM3 | 1630 RUSTIC COURT WALL, NJ 07753 | GUARDIAN | $5K | — | $5K | 4.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SNYADS THIRD PARTY ADMIN | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | PO BOX 7347 ALBANY, NY 12224 | $695K |
| SYRACUSE AUTO DEALERS ASSOCIATION INSURANCE AGENT | Insurance agents and brokers Service code 22 | 770 JAMES STREET SYRACUSE, NY 13203 | $255K |
| BENEFIT MALL INSURANCE AGENT | Insurance agents and brokers Service code 22 | 372 SOUTH PLANK ROAD NEWBURGH, NY 12550 | $95K |
| GUNDERMANN & GUNDERMANN INSURANCE AGENT | Insurance agents and brokers Service code 22 | WEST CARVER STREET HUNTINGTON, NY 11743 | $72K |
| RUSSELL-TAKATS INSURANCE AGENCY INC INSURANCE AGENT | Insurance agents and brokers Service code 22 | 130 CHRIS LANE WEST ISLIP, NY 11795 | $65K |
| EXPRESS SCRIPTS EIN 22-3461740 CONTRACT ADMINISTRATOR | Contract Administrator; Other fees; Claims processing Service code 12 | — | $65K |
| THE PARTNERS INSURANCE INSURANCE AGENT | Insurance agents and brokers Service code 22 | PARKWAY WEST VESTAL, NY 13850 | $63K |
| EBIX HEALTH INC. EIN 77-0021975 COMPUTER CONSULTANT | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $50K |
| GANIM FINANCIAL SERVICES INSURANCE AGENT | Insurance agents and brokers Service code 22 | C/O THE GANIM GROUP INC. 2429 NORTH AVENUE BRIDGEPORT, CT 06604 | $40K |
| UPSTATE CONSULTING INSURANCE AGENT | Insurance agents and brokers Service code 22 | 514 STATE STREET, SUITE 3 SCHENECTADY, NY 12305 | $35K |
| SADLER HAYES ASSOCIATES INC INSURANCE AGENT | Insurance agents and brokers Service code 22 | 64 ROLLINGS RIDGE ROAD NEW CITY, NY 10956 | $34K |
| ADMIRAL INSURANCE BROKERAGE INSURANCE AGENT | Insurance agents and brokers Service code 22 | 6833 SHORE ROAD BROOKLYN, NY 11220 | $23K |
| MANG INSURANCE AGENCY INSURANCE AGENT | Insurance agents and brokers Service code 22 | 66 SOUTH BROAD STREET NORWICH, NY 13815 | $22K |
| FOA & SONS CORP INSURANCE AGENT | Insurance agents and brokers Service code 22 | 68 SO. SERVICE ROAD MELVILLE, NY 11747 | $20K |
| BROWN & BROWN OF EMPIRE STATE INSURANCE AGENT | Insurance agents and brokers Service code 22 | 500 PLUM STREET, SUITE 200 SYRACUSE, NY 13204 | $20K |
| THE WLADIS COMPANIES INSURANCE AGENT | Insurance agents and brokers Service code 22 | 528 PLUM COURT SYRACUSE, NY 13204 | $16K |
| WEST & COMPANY CPA'S PC ACCOUNTANT | Accounting (including auditing) Service code 10 | 97 NORTH MAIN STREET PO BOX 1219 GLOVERSVILLE, NY 12078 | $15K |
| COLLEY ASSET MANAGEMENT INC. EIN 14-1769528 INVESTMENT ADVISOR | Investment management Service code 28 | — | $14K |
| BLUE OCEAN BENEFITS & CONSULTING INSURANCE AGENT | Insurance agents and brokers Service code 22 | 1933 HIGHWAY 35, SUITE 354 WALL, NJ 07719 | $12K |
| MARSHALL & STERLING INSURANCE AGENT | Insurance agents and brokers Service code 22 | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | $11K |
| NIXON PEABODY LLP LEGAL PROVIDER | Legal Service code 29 | 677 BROADWAY, 10TH FLOOR ALBANY, NY 12207 | $9K |
| FOCUSED TECHNOLOGIES IMAGING SERVIC RECORDKEEPING FEES | Recordkeeping fees Service code 64 | 6 AIRLINE DRIVE ALBANY, NY 12205 | $8K |
| GALLAGHER BENEFIT SERVICES INSURANCE AGENT | Insurance agents and brokers Service code 22 | 677 BROADWAY 4TH FLOOR ALBANY, NY 12207 | $7K |
| NIAGARA FRONTIER AUTO DEALERS ASSOC INSURANCE AGENT | Insurance agents and brokers Service code 22 | 1144 WEHRLE DRIVE WILLIAMSVILLE, NY 14221 | $7K |
| DAVID PRATT LEGAL SERVICES | Legal Service code 29 | 80 NEW SCOTLAND AVE. ALBANY, NY 12208 | $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 | 7,201 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 7,201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 2,182 | $13.5M |
| Dental(2 contracts, 2 carriers) | GUARDIAN | 2,791 | $157K |
| Life insurance(2 contracts, 2 carriers) | THE HARTFORD | 2,324 | $268K |
| Short-term disability | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | 0 | $79K |
| Prescription drug(3 contracts, 3 carriers) | HEALTHNOW NEW YORK INC. DBA BLUE CROSS BLUE SHIELD OF WESTERN NY | 3,277 | $30.5M |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUECROSS BLUESHIELD | 2,182 | $13.5M |
| Other(2 contracts, 2 carriers) | HEALTHNOW NEW YORK INC. DBA BLUE CROSS BLUE SHIELD OF WESTERN NY | 3,277 | $16.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,277 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.