| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ONEGROUP NY INC3 Filed as: ONEGROUP NY, INC | 706 N CLINTON STREET SYRACUSE, NY 13204 | EXCELLUS BLUE CROSS BLUE SHIELD | $75K | — | $75K | 3.50% |
| PETER DERRENBACKER3 | PO BOX 4718 SYRACUSE, NY 13221 | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | — | $21K | $21K | 9.38% |
| PETER DERRENBACKER3 | 34 ASPEN PARK BLVD E SYRACUSE, NY 10357 | NORTHWESTERN MUTUAL | $6K | $2K | $8K | 3.66% |
| RP DODD GROUP INC3 Filed as: R P DODD GROUP INC | 34 ASPEN PARK BLVD E SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $1K | $145 | $1K | 0.65% |
| ONEGROUP NY INC3 Filed as: ONEGROUP NY, INC | 706 N CLINTON STREET SYRACUSE, NY 13204 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 2.61% |
| PETER DERRENBACKER3 | PO BOX 4718 SYRACUSE, NY 13221 | FIRST UNUM LIFE INSURANCE COMPANY | $23K | — | $23K | 19.99% |
| ONEGROUP NY INC3 Filed as: ONEGROUP NY, INC | 706 N CLINTON STREET SYRACUSE, NY 13204 | HM LIFE INSURANCE COMPANY OF NEW YORK | $0 | $0 | $0 | 0.00% |
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 | 423 | 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) | 426 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 246 | $2.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 705 | $193K |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 247 | $23K |
| Life insurance | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | 369 | $220K |
| Long-term disability | NORTHWESTERN MUTUAL | 421 | $207K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 246 | $2.1M |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 113 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 705 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.