| 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 PLAN | $74K | — | $74K | 3.55% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN EMPIRE STATE | 500 PLUM STREET, SUITE 200 SYRACUSE, NY 13204 | EXCELLUS BLUE CROSS/BLUE SHIELD PLAN | $83 | — | $83 | 0.00% |
| ONEGROUP NY INC3 Filed as: ONEGROUP NY, INC. | 706 NORTH CLINTON STREET SYRACUSE, NY 13204 | MVP HEALTH CARE | $5K | — | $5K | 3.97% |
| ONEGROUP NY INC3 Filed as: ONEGROUP NY, INC. | 706 NORTH CLINTON STREET SYRACUSE, NY 13204 | METLIFE LIFE INSURANCE COMPANY | $4K | — | $4K | — |
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 | 975 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 975 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EXCELLUS BLUE CROSS/BLUE SHIELD PLAN | 175 | $2.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NEW YORK | 699 | $395K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 852 | $232K |
| Short-term disability(2 contracts) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 852 | $245K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 125 | $38K |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUE CROSS/BLUE SHIELD PLAN | 410 | $74K |
| Other | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 852 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 852 | — |
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.