| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: HAYLOR FREYER COON INC | 231 SALINA MEADOWS SYRACUSE, NY 13212 | EXCELLUS BLUECROSS BLUESHIELD | $89K | — | $89K | 2.88% |
| ACRISURE LLC3 Filed as: HAYLOR FREYER & COON INC | 231 SALINA MEADOWS SYRACUSE, NY 13221 | GUARDIAN | $5K | — | $5K | 2.32% |
| WAG NY INC3 | 250 CROSSWAYS PARK DRIVE WOODBURY, NY 11797 | GUARDIAN | $208 | — | $208 | 0.09% |
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON INC | 231 SALINA MEADOWS SYRACUSE, NY 13221 | GUARDIAN | $11K | — | $11K | 6.20% |
| WAG NY INC3 | 250 CROSSWAYS PARK DRIVE WOODBURY, NY 11797 | GUARDIAN | $141 | — | $141 | 0.08% |
| ACRISURE LLC3 Filed as: HAYLOR FREYER & COON INC | 231 SALINA MEADOWS SYRACUSE, NY 13221 | GUARDIAN | $3K | — | $3K | 6.22% |
| WAG NY INC3 | 250 CROSSWAYS PARK DRIVE WOODBURY, NY 11797 | GUARDIAN | $28 | — | $28 | 0.07% |
| JEFFREY GREENBLOTT3 | 609 EAST MAIN STREET ENDICOTT, NY 13770 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $25 | $2K | 7.09% |
| GREGORY L ULATOWSKI3 Filed as: GREGORY ULATOWSKI | 305 PLYMOUTH DRIVE SYRACUSE, NY 13206 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $19 | $1K | 3.86% |
| HEATHER MARIE SODON3 | 17485 STATE RTE 167 MONTROSE, PA 18801 | THE PAUL REVERE LIFE INSURANCE COMPANY | $37 | $0 | $37 | 0.12% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY MANGIONE | 1380 DUNCAN LOOP SOUTH DUNEDIN, FL 34698 | THE PAUL REVERE LIFE INSURANCE COMPANY | $26 | $0 | $26 | 0.09% |
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 | 322 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 46 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 368 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 249 | $3.1M |
| Dental | GUARDIAN | 250 | $224K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 357 | $24K |
| Life insurance | GUARDIAN | 644 | $180K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN | 325 | $72K |
| Long-term disability | GUARDIAN | 644 | $180K |
| Other | GUARDIAN | 644 | $180K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 644 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.