| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT SERVICES GROUP, INC.3 | 23671 LAWLER DRIVE WATERTOWN, NY 13601 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $42K | $39K | $81K | 5.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | 165 COURT STREET ROCHESTER, NY 14647 | $690K |
| PROACT, INC. EIN 15-0358720 PHARMACY BENEFITS MANAGER | Account maintenance fees Service code 65 | 6333 ROUTE 298 EAST SYRACUSE, NY 13057 | $14K |
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 | 1,307 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 1,307 | $512K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,358 | $1.4M |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,358 | $1.4M |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,358 | $1.4M |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 1,307 | $512K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,358 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.