| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AFS AGENCY3 | 185 GENESEE STREET, 2ND FL UTICA, NY 13501 | EXCELLUS BLUE CROSS BLUE SHIELD | $40K | — | $40K | 4.29% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE STREET, SUITE 210 UTICA, NY 13501 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE STREET, SUITE 210 UTICA, NY 13501 | DELTA DENTAL | $3K | — | $3K | 29.92% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE STREET, SUITE 210 UTICA, NY 13501 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| AFS AGENCY3 | 185 GENESEE STREET, SUITE 210 UTICA, NY 13501 | HM LIFE INSURANCE CO OF NY | $864 | — | $864 | 10.00% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE STREET, SUITE 210 UTICA, NY 13501 | FIRST UNUM LIFE INSURANCE COMPANY | $669 | — | $669 | 9.99% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE STREET, SUITE 210 UTICA, NY 13501 | FIRST UNUM LIFE INSURANCE COMPANY | $460 | — | $460 | 10.00% |
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 | 70 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 71 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 71 | $939K |
| Dental | DELTA DENTAL | 89 | $10K |
| Vision | HM LIFE INSURANCE CO OF NY | 90 | $9K |
| Life insurance(3 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 89 | $21K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 37 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 90 | — |
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.