| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN EMPIRE STATE | 500 PLUM STREET SYRACUSE, NY 13204 | EXCELLUS BLUECROSS BLUESHIELD PLAN | $92K | — | $92K | 2.99% |
| NBT INSURANCE AGENCY LLC3 Filed as: NBT INS AGENCY LLC | 66 SOUTH BROAD ST STE 2 NORWICH, NY 13815 | HARTFORD LIFE INSURANCE COMPANY | $148 | $3 | $151 | 15.30% |
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 | 100 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 422 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD PLAN | 231 | $3.1M |
| Dental | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 474 | $172K |
| Life insurance | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 303 | $120K |
| Long-term disability | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 303 | $120K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD PLAN | 231 | $3.1M |
| Other(2 contracts, 2 carriers) | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 303 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 474 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.