| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 | 432 N FRANKLIN ST, SUITE 20 SYRACUSE, NY 13204 | FIRST SYMETRA NATIONAL LIFE INS CO OF NEW YORK | $47K | — | $47K | 15.00% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | BERKLEY LIFE AND HEALTH INSURANCE CO | $27K | — | $27K | 15.00% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | MUTUAL OF OMAHA INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | COMPANION LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET SYRACUSE, NY 13204 | COMPANION LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT,LLC | 432 N FRANKLIN ST, SUITE 20 SYRACUSE, NY 13204 | GUARDIAN | — | $274 | $274 | 0.97% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | — | $1K | 7.00% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | MUTUAL OF OMAHA INSURANCE COMPANY | $632 | — | $632 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGER | Direct payment from the plan; Claims processing; Float revenue; Other fees Service code 12 | — | $1.4M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $173K |
| CROWN RISK MANAGEMENT, LLC EIN 20-2318765 BROKER | Other commissions Service code 55 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | $56K |
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 | 2,203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 496 | $28K |
| Vision | GUARDIAN | 496 | $28K |
| Life insurance(2 contracts) | COMPANION LIFE INSURANCE COMPANY | 1,245 | $114K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 240 | $90K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 96 | $17K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | FIRST SYMETRA NATIONAL LIFE INS CO OF NEW YORK | 302 | $495K |
| Other(3 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 1,245 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,245 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.