| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 70 LINDEN OAKS SUITE 210 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $88K | — | $88K | 2.20% |
| PETER DERRENBACKER3 | 34 ASPEN PARK BOULEVARD EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $7K | $2K | $9K | 2.78% |
| M C DOOLITTLE GROUP LLC3 Filed as: M C DOOLITTLE GROUP, LLC | 34 ASPEN PARK BOULEVARD EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $1K | $166 | $2K | 0.50% |
| PETER DERRENBACKER3 | 34 ASPEN PARK BOULEVARD EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $5K | $1K | $7K | 2.46% |
| M C DOOLITTLE GROUP LLC3 Filed as: M C DOOLITTLE GROUP, LLC | 34 ASPEN PARK BOULEVARD EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $1K | $125 | $1K | 0.44% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF NEW YORK | $12K | $0 | $12K | 5.00% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35, SUITE 368 WALL, NJ 07719 | DELTA DENTAL OF NEW YORK | $12K | $0 | $12K | 5.00% |
| PETER DERRENBACKER3 Filed as: PETER L DERRENBACKER | 34 ASPEN PARK BOULEVARD EAST SYRACUSE, NY 13057 | FIRST UNUM LIFE INSURANCE COMPANY | $19K | $0 | $19K | 20.00% |
| PETER DERRENBACKER3 | 34 ASPEN PARK BOULEVARD EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $3K | $775 | $4K | 6.81% |
| M C DOOLITTLE GROUP LLC3 Filed as: M C DOOLITTLE GROUP, LLC | 34 ASPEN PARK BOULEVARD EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $585 | $70 | $655 | 1.20% |
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 | 484 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 490 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 257 | $4.0M |
| Dental | DELTA DENTAL OF NEW YORK | 515 | $240K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 470 | $23K |
| Life insurance | NORTHWESTERN MUTUAL | 416 | $268K |
| Short-term disability | NORTHWESTERN MUTUAL | 288 | $54K |
| Long-term disability | NORTHWESTERN MUTUAL | 477 | $312K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 257 | $4.0M |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 100 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 515 | — |
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."
No prospect flags tripped on this filing.