| 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 SUITE 200 SYRACUSE, NY 13204 | EXCELLUS BLUECROSS BLUESHIELD | $73K | — | $73K | 3.59% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EXCELLUS BLUECROSS BLUESHIELD | -$41 | — | -$41 | -0.00% |
| BRIAN MCLAUCHLAN3 | 303 FOREST DR NORTH SYRACUSE, NY 13212 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7K | $6K | $12K | 13.43% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7K | — | $7K | 7.06% |
| SUSAN SMITH3 | 1216 LANDRUSH WAY BALDWINSVILLE, NY 13027 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4K | $526 | $4K | 4.34% |
| MICHAEL L O'DONNELL3 | 133 HAZELHURST AVE NORTH SYRACUSE, NY 13212 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $2K | $4K | 4.31% |
| BRIAN MCLAUCHLAN3 | 303 FOREST DR NORTH SYRACUSE, NE 13212 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7K | $6K | $12K | 13.43% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM STREET SUITE 200 SYRACUSE, NY 13204 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7K | — | $7K | 7.06% |
| SUSAN SMITH3 | 1216 LANDRUSH WAY BALDWINSVILLE, NY 13027 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4K | $526 | $4K | 4.34% |
| MICHAEL L O'DONNELL3 | 133 HAZELHURST AVE N SYRACUSE, NY 13212 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $2K | $4K | 4.31% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | HM LIFE INSURANCE COMPANY OF NEW YORK | $3K | — | $3K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $3K | — | $3K | 12.39% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $175 | $512 | $687 | 3.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC. | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $126 | $2K | 10.42% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST SYRACUSE, NY 13204 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $99 | $2K | 14.37% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 22113 FABCO RD WATERTOWN, NY 13601 | FIRST UNUM LIFE INSURANCE COMPANY | $387 | $19 | $406 | 2.82% |
| ROBERT DUHOSKI3 | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $297 | — | $297 | 5.49% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 22113 FABCO RD WATERTOWN, NY 13601 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $192 | — | $192 | 3.55% |
| ENV INSURANCE AGENCY LLC3 Filed as: ENV INSURANCE AGENCY | 7789 OSWEGO RD LIVERPOOL, NE 13090 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $23 | — | $23 | 0.43% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 22113 FABCO RD WATERTOWN, NY 13601 | FIRST UNUM LIFE INSURANCE COMPANY | $13 | — | $13 | 1.06% |
| ENV INSURANCE AGENCY LLC3 Filed as: ENV FINANCIAL SERVICES | 7789 OSWEGO RD LIVERPOOL, NY 13090 | FIRST UNUM LIFE INSURANCE COMPANY | $12 | — | $12 | 0.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFETIME BENEFIT SOLUTIONS, INC. EIN 16-1171765 TPA HRA | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $11K |
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 | 338 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EXCELLUS BLUECROSS BLUESHIELD | 236 | $2.1M |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 194 | $26K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 337 | $17K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 14 | $7K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 338 | $23K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 235 | $2.0M |
| Other(3 contracts, 2 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 337 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 338 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.