| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LILA MARKETING LLC | — | DAVIS VISION | $115K | — | $115K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | 333 BUTTERNUT DRIVE SYRACUSE, NY 13214 | $4.0M |
| SIMPLY PRESCRIPTIONS EIN 15-0329043 NONE | Other services Service code 49 | 165 COURT STREET ROCHESTER, NY 14647 | $639K |
| EXPRESS SCRIPTS EIN 22-3461740 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | 225 SUMMIT AVENUE MONTVALE, NJ 07645 | $631K |
| LIFETIME BENEFIT SOLUTIONS EIN 16-1171765 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | 115 CONTINUM DRIVE LIVERPOOL, NY 13088 | $404K |
| SOLID BENEFIT GUIDANCE, LLC EIN 20-2532319 NONE | Consulting (general); Direct payment from the plan Service code 16 | 228 RIVERVALE ROAD RIVERVALE, NJ 07675 | $244K |
| BLITMAN & KING, LLP EIN 16-1047304 NONE | Legal; Direct payment from the plan Service code 29 | 443 NORTH FRANKLIN STREET SYRACUSE, NY 13204 | $198K |
| ONE GROUP EIN 16-1593071 NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | 5232 WITZ DRIVE NORTH SYRACUSE, NY 13212 | $159K |
| LINDA DEROCHER EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $121K |
| KENNETH STILWELL EIN 15-0551885 NONE | Direct payment from the plan; Employee (plan) Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $112K |
| PARAVATI,KARL,GREEN & DEBELLA EIN 16-1284656 NONE | Legal; Direct payment from the plan Service code 29 | 12 STEUBEN PARK UTICA, NY 13501 | $96K |
| MARILYN RYAN EIN 15-0551885 NONE | Direct payment from the plan; Employee (plan) Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $93K |
| DEBORA LOIACANO EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $92K |
| CNORA COOPER EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $80K |
| MICHELE CALCAGINO EIN 15-0551885 NONE | Direct payment from the plan; Employee (plan) Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $73K |
| JOHN TIERNEY EIN 15-0551885 NONE | Direct payment from the plan; Employee (plan) Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $72K |
| D'ARCANGELO & CO., LLP EIN 13-2550103 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 120 LOMOND COURT UTICA, NY 13502 | $71K |
| JACQUELINE TOWNSEND EIN 15-0551885 NONE | Direct payment from the plan; Employee (plan) Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $71K |
| JOSEPH SALERNO EIN 15-0551885 NONE | Direct payment from the plan; Employee (plan) Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $69K |
| THOMAS NANNA EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $67K |
| STATE STREET BANK AND TRUST EIN 04-1867445 NONE | Direct payment from the plan; Custodial (securities); Investment management Service code 19 | 200 NEWPORT AVENUE QUINCY, MA 02171 | $64K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | 100 LOWDER BROOK DRIVE WESTWOOD, MA 02090 | $64K |
| RUSSELL MORREALE EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $63K |
| TIMOTHY RICH EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $59K |
| FRANCES KNEPKA EIN 15-0551885 NONE | Direct payment from the plan; Employee (plan) Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $57K |
| MICHELE MATT EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $54K |
| KRISTIN ALLEN EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $52K |
| MORGAN, LEWIS & BOCKIUS EIN 23-0891050 NONE | Legal; Direct payment from the plan Service code 29 | PO BOX 8500 S-6050 PHILADELPHIA, PA 19178 | $52K |
| BARBARA ACEY EIN 15-0551885 NONE | Direct payment from the plan; Employee (plan) Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $49K |
| ROSEMARY INSALCO EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $48K |
| MICHELLE DEEMER EIN 15-0551885 NONE | Direct payment from the plan; Employee (plan) Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $47K |
| ROBERT KELLEY EIN 15-0551885 NONE | Direct payment from the plan; Employee (plan) Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $46K |
| SHANNON ROBERTS EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $43K |
| REGINA DEMARCO EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE SYRACUSE, NY 13221 | $35K |
| CINDY FARINA EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE NORTH SYRACUSE, NY 13221 | $33K |
| LESLY DEBUQUE EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE NORTH SYRACUSE, NY 13221 | $32K |
| KIM CUNNINGHAM EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE NORTH SYRACUSE, NY 13221 | $32K |
| KRISTI EDICK EIN 15-0551885 NONE | Employee (plan); Direct payment from the plan Service code 30 | 151 NORTHERN CONCOURSE NORTH SYRACUSE, NY 13221 | $29K |
| CR FLETCHER TEMPS INC EIN 16-1504346 NONE | Other services; Direct payment from the plan Service code 49 | 126 N SALINA STREET SYRACUSE, NY 13202 | $26K |
| HONEYWELL EIN 22-2640650 NONE | Direct payment from the plan; Other fees Service code 50 | 4705 CROSSROADS PARK DRIVE LIVERPOOL, NY 13088 | $24K |
| M.A. POLCE CONSULTING EIN 99-9999999 NONE | Consulting (general); Direct payment from the plan Service code 16 | 401 PHOENIX DRIVE ROME, NY 13441 | $22K |
| NORTHLAND COMMUNICATIONS EIN 16-1188181 NONE | Direct payment from the plan; Other services Service code 49 | 9560 MAIN STREET HOLLAND PATENT, NY 13354 | $20K |
| INDUSTRIAL CONTRACTING EIN 99-9999999 NONE | Direct payment from the plan; Consulting (general) Service code 16 | 914 EMERSON AVE SYRACUSE, NY 13204 | $20K |
| CORPORATE MAINTENANCE SYSTEMS EIN 16-1498422 NONE | Direct payment from the plan; Other services Service code 49 | 7658 WINDSOR DR N SYRACUSE, NY 13212 | $19K |
| IMMEDIATE MAILING SERVICE EIN 16-1313143 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 245 COMMERCE BLVD LIVERPOOL, NY 13088 | $16K |
| CHARLES J. HOFMANN EIN 99-9999999 NONE | Other services Service code 49 | 325 NORTHERN BOULEVARD ALBANY, NY 12204 | $15K |
| BCD SOFTWARE, LLC EIN 46-4628059 NONE | Other services Service code 49 | 1333 BURR RIDGE PARKWAY SUITE 200 BURR RIDGE, IL 60527 | $9K |
| WB MASON COMPANY EIN 04-2455641 NONE | Direct payment from the plan; Other services Service code 49 | PO BOX 981101 BOSTON, MA 02298 | $9K |
| EXCEL SYSTEMS SOFTWARE DEVELOP EIN 99-9999999 NONE | Other services Service code 49 | — | $8K |
| LANPHEAR LANDSCAPES EIN 16-1390463 NONE | Direct payment from the plan; Other services Service code 49 | 2018 NEW BOSTON STREET CHITTENANGO, NY 13037 | $8K |
| TC PETERS PRINTING INC EIN 16-0983559 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 2336 W WHITESBORO STREET UTICA, NY 13502 | $8K |
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 | 12,572 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 155 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 12,727 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | EXCELLUS BLUECROSS BLUESHIELD PLAN | 266 | $3.7M |
| Vision | DAVIS VISION | 46,061 | $2.3M |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 9,142 | $1.1M |
| Short-term disability | UNION LABOR LIFE INSURANCE CO | 9,296 | $1.9M |
| Prescription drug(5 contracts, 4 carriers) | EXCELLUS BLUECROSS BLUESHIELD PLAN | 266 | $3.7M |
| Other(2 contracts, 2 carriers) | MOYER RUSSI AND RANDALL, PC | 9,142 | $2.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 46,061 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.