| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 | 221 S WARREN STREET SUITE 100 SYRACUSE, NY 13204 | EXCELLUS BLUE CROSS BLUE SHIELD | $95K | — | $95K | 3.40% |
| CROWN RISK MANAGEMENT, LLC3 | 221 S WARREN STREET SUITE 100 SYRACUSE, NY 13204 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 2.64% |
| VALERIE J CLARK4 Filed as: VALERIE J. CLARK | 9425 DOUBLE R BLVD SUITE F RENO, NV 89521 | FIDELITY SECURITY LIFE INS CO OF NY | $2K | — | $2K | 6.33% |
| CROWN RISK MANAGEMENT, LLC3 | 221 S WARREN STREET SUITE 100 SYRACUSE, NY 13204 | SHELTERPOINT LIFE INSURANCE COMPANY | $2K | — | $2K | 11.00% |
| CROWN RISK MANAGEMENT, LLC3 | 221 S WARREN STREET SUITE 100 SYRACUSE, NY 13204 | SUN LIFE AND HEALTH INSURANCE COMPANY | $117 | — | $117 | 2.93% |
| CROWN RISK MANAGEMENT, LLC3 | 221 S WARREN STREET SUITE 100 SYRACUSE, NY 13204 | SUN LIFE AND HEALTH INSURANCE COMPANY | $362 | — | $362 | 29.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC EIN 20-2318765 BROKER | Claims processing Service code 12 | 221 S WARREN STREET SYRACUSE, NY 132021859 | $103K |
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 | 490 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 490 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 286 | $2.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 490 | $188K |
| Vision | FIDELITY SECURITY LIFE INS CO OF NY | 331 | $24K |
| Short-term disability(2 contracts, 2 carriers) | SHELTERPOINT LIFE INSURANCE COMPANY | 376 | $22K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY | 296 | $4K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 286 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.