| 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 | $55K | — | $55K | 1.86% |
| ONE GROUP NY INC3 Filed as: ONE GROUP NY, INC. | 706 NORTH CLINTON STREET SYRACUSE, NY 13204 | EXCELLUS BLUE CROSS BLUE SHIELD | $32K | $0 | $32K | 1.09% |
| PETER DERRENBACKER3 | 6170 HEMINGWAY ROAD JAMESVILLE, NY 13057 | STANDARD OF NEW YORK | $13K | $2K | $15K | 6.05% |
| PETER DERRENBACKER3 | 34 ASPEN PARK BOULEVARD EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $6K | $2K | $8K | 3.34% |
| M C DOOLITTLE GROUP LLC3 Filed as: M.C. DOOLITTLE GROUP, LLC | 34 ASPEN PARK BOULEVARD EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $1K | $123 | $1K | 0.48% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES, LLC | 1933 STATE ROUTE 35, SUITE 368 WALL, NJ 07719 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $1K | $12K | 5.48% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $2K | $5K | 2.47% |
| ONE GROUP NY INC3 Filed as: ONE GROUP NY, INC. | 706 NORTH CLINTON STREET SYRACUSE, NY 13204 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 1.41% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $14 | $14 | 0.01% |
| PETER DERRENBACKER3 | 34 ASPEN PARK BOULEVARD EAST SYRACUSE, NY 13057 | FIRST UNUM LIFE INSURANCE COMPANY | $26K | $0 | $26K | 19.98% |
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 | 239 | 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) | 242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 233 | $2.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 639 | $218K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 415 | $20K |
| Life insurance | STANDARD OF NEW YORK | 369 | $244K |
| Long-term disability | NORTHWESTERN MUTUAL | 428 | $239K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 233 | $2.9M |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 112 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 639 | — |
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.