| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 | 432 N. FRANKLIN ST. SUITE 20 SYRACUSE, NY 13204 | SUN LIFE AND HEALTH INSURANCE COMPANY | — | $58K | $58K | 15.00% |
| UMR, INC.3 Filed as: UMR | 115 W. WAUSAU AVE. WAUSAU, WI 54401 | SUN LIFE AND HEALTH INSURANCE COMPANY | — | $2K | $2K | 0.52% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | BERKLEY LIFE AND HEALTH INSURANCE CO | — | $38K | $38K | 15.00% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | COMPANION LIFE INSURANCE COMPANY | — | $9K | $9K | 10.00% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET SYRACUSE, NY 13204 | COMPANION LIFE INSURANCE COMPANY | — | $6K | $6K | 10.00% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT,LLC | 432 N FRANKLIN ST, SUITE 20 SYRACUSE, NY 13204 | GUARDIAN | — | $310 | $310 | 0.87% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $2K | $2K | 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 | — | $107K | $107K | 1000.02% |
| CROWN RISK MANAGEMENT, LLC3 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $854 | $854 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGER | Direct payment from the plan; Claims processing; Other fees; Float revenue Service code 12 | — | $1.8M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $297K |
| CROWN RISK MANAGEMENT, LLC EIN 20-2318765 BROKER | Other commissions Service code 55 | 432 NORTH FRANKLIN STREET, STE 20 SYRACUSE, NY 13204 | $61K |
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 | 1,370 | 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) | 1,370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 543 | $36K |
| Vision | GUARDIAN | 543 | $36K |
| Life insurance(2 contracts) | COMPANION LIFE INSURANCE COMPANY | 1,370 | $144K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 330 | $11K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 115 | $17K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SUN LIFE AND HEALTH INSURANCE COMPANY | 345 | $636K |
| Other(3 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 1,370 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,370 | — |
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.