| 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 | $72K | — | $72K | 3.90% |
| 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% |
| 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 | 5.92% |
| BRIAN MCLAUCHLAN3 | 303 FOREST DR NORTH SYRACUSE, NE 13212 | THE PAUL REVERE LIFE INSURANCE COMPANY | $6K | $104 | $6K | 4.84% |
| SUSAN SMITH3 | 1216 LANDRUSH WAY BALDWINSVILLE, NY 13027 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4K | $8 | $4K | 3.09% |
| MICHAEL L O'DONNELL3 | 133 HAZELHURST AVE NORTH SYRACUSE, NY 13212 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $97 | $2K | 1.31% |
| SHEILA ANN WILSON3 | 32 SHARYL DRIVE CENTRAL SQUARE, NY 13036 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $92 | $95 | 0.08% |
| 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 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $3K | — | $3K | 14.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA | 220 S RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $827 | $827 | 4.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC. | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | — | $2K | 10.89% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA | 220 S RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $672 | $672 | 4.73% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST SYRACUSE, NY 13204 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $1K | — | $1K | 15.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA | 220 S RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $491 | $491 | 4.96% |
| 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 | $145 | — | $145 | 2.53% |
| ENV INSURANCE AGENCY LLC3 | 7789 OSWEGO RD LIVERPOOL, NY 13090 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $17 | — | $17 | 0.30% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 22113 FABCO RD WATERTOWN, NY 13601 | FIRST UNUM LIFE INSURANCE COMPANY | $12 | — | $12 | 1.26% |
| EDWARD D YATES3 Filed as: EDWARD N VAUGHN | 7789 OSWEGO RD LIVERPOOL, NY 13090 | FIRST UNUM LIFE INSURANCE COMPANY | $10 | — | $10 | 1.05% |
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 | 361 | 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) | 361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EXCELLUS BLUECROSS BLUESHIELD | 227 | $2.0M |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 200 | $27K |
| Life insurance(2 contracts) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 361 | $24K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 12 | $7K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 361 | $18K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 227 | $1.9M |
| Other(2 contracts) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 361 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 361 | — |
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.