| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS INC - EMPIRE | 500 PLUM STREET STE 200 SYRACUSE, NY 13204 | EXCELLUS BLUE CROSS BLUE SHIELD | $66K | — | $66K | 3.59% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN EMPIRE STATE | 500 PLUM STREET STE 200 SYRACUSE, NY 13204 | EXCELLUS BLUE CROSS BLUE SHIELD | $7K | — | $7K | 0.39% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 45 EAST AVE ROCHESTER, NY 10604 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | $1K | $3K | 9.68% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $3K | — | $3K | 8.74% |
| STRATEGIC NON-MEDICAL SOLUTION3 Filed as: STRATEGIC NON-MEDICAL SLTNS INC | ONE BEACON ST STE 17100 BOSTON, MA 02108 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $512 | $512 | 1.67% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 45 EAST AVE ROCHESTER, NY 10604 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $677 | $1K | $2K | 6.66% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | — | $2K | 6.30% |
| STRATEGIC NON-MEDICAL SOLUTION3 Filed as: STRATEGIC NON-MEDICAL SLTNS INC | ONE BEACON ST STE 17100 BOSTON, MA 02108 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $421 | $421 | 1.64% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | — | $2K | 8.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 45 EAST AVE ROCHESTER, NY 10604 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $966 | $891 | $2K | 8.72% |
| STRATEGIC NON-MEDICAL SOLUTION3 Filed as: STRATEGIC NON-MEDICAL SLTNS INC | ONE BEACON ST STE 17100 BOSTON, MA 02108 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $336 | $336 | 1.58% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 45 EAST AVE ROCHESTER, NY 10604 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $462 | $448 | $910 | 8.30% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $825 | — | $825 | 7.53% |
| STRATEGIC NON-MEDICAL SOLUTION3 Filed as: STRATEGIC NON-MEDICAL SLTNS INC | ONE BEACON ST STE 17100 BOSTON, MA 02108 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $177 | $177 | 1.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 45 EAST AVE ROCHESTER, NY 10604 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $109 | $70 | $179 | 10.26% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $153 | — | $153 | 8.77% |
| STRATEGIC NON-MEDICAL SOLUTION3 Filed as: STRATEGIC NON-MEDICAL SLTNS INC | ONE BEACON ST STE 17100 BOSTON, MA 02108 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $29 | $29 | 1.66% |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 146 | $1.8M |
| Dental | MVP SELECT CARE | 148 | $8K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 190 | $11K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 93 | $26K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 187 | $21K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 146 | $1.8M |
| Other(3 contracts) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 190 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.