| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ONEGROUP NY INC3 Filed as: ONEGROUP NY, INC | 706 N CLINTON ST SYRACUSE, NY 13204 | EXCELLUS BLUE CROSS BLUE SHIELD | $92K | — | $92K | 2.80% |
| ONEGROUP NY INC3 | 706 N CLINTON ST SYRACUSE, NY 13204 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $10K | — | $10K | 5.78% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $8K | — | $8K | 5.01% |
| ONEGROUP NY INC3 | 706 N CLINTON ST SYRACUSE, NY 13204 | FIRST UNUM LIFE INSURANCE COMPANY | $15K | — | $15K | 15.03% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | — | $5K | 5.01% |
| ONEGROUP NY INC3 | 706 N CLINTON ST SYRACUSE, NY 13204 | FIRST UNUM LIFE INSURANCE COMPANY | $14K | — | $14K | 15.01% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| JENNIFER DICK3 | 891 BABCOCK LAKE ROAD PETERSBURG, NY 12138 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $695 | — | $695 | 3.33% |
| ANDREW THOMAS3 | 4802 BURRSTONE RD SYRACUSE, NY 13215 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $566 | $14 | $580 | 2.78% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 N FRANKLIN ST STE 20 SYRACUSE, NY 13204 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $454 | — | $454 | 2.18% |
| JOSEPH P CALARCO3 | PO BOX 130 AUBURN, NY 13021 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $331 | $3 | $334 | 1.60% |
| LAURA ANNE CALARCO3 Filed as: LAURA CALARCO | 340 HORSE CREEK DR APT 208 NAPLES, FL 34110 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $148 | $3 | $151 | 0.72% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $82 | — | $82 | 0.39% |
| BRAD JONES AND ASSOCIATES INC3 | 19 BRITISH AMERICAN BLVD LATHAM, NY 12110 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $62 | — | $62 | 0.30% |
| ONEGROUP NY INC3 | 706 N CLINTON ST SYRACUSE, NY 13204 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $35 | — | $35 | 0.17% |
| KELLY A IRVINE3 Filed as: KELLY IRVINE | 15801 WHITE ORCHID LN FORT MYERS, FL 33908 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $28 | — | $28 | 0.13% |
| KEVIN MURPHY3 | 11 WILLOWBROOK TERRACE CLIFTON PARK, NY 12065 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $21 | — | $21 | 0.10% |
| SHAWN DALY3 | 2287 CENTER ROAD SCIPIO CENTER, NY 13147 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $17 | — | $17 | 0.08% |
| BRENDAN MCCARTHY AND CREW INC3 | 39 SAGINAW DR STE 2 ROCHESTER, NY 14623 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $15 | — | $15 | 0.07% |
| STEPHEN R CONNORS3 | 108 HUNTSHILL RD SYRACUSE, NY 13209 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $1 | — | $1 | 0.00% |
| JUSTIN M. BYMASTER3 Filed as: JUSTIN M BYMASTER | 447 STATE ROUTE 104A STERLING, NY 13156 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $0 | — | $0 | 0.00% |
| NICHOLAS CALARCO3 | 162 YORK ST AUBURN, NY 13021 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $0 | — | $0 | 0.00% |
| EDWARD D YATES JR3 Filed as: EDWARD YATES JR | 2063 COUNTY ROUTE 8 OSWEGO, NY 13126 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $0 | — | $0 | 0.00% |
| CORY D NELSON3 Filed as: CORY NELSON | 215 HIGHWAY 965 NE STE 3 NORTH LIBERTY, IA 52317 | AFLAC | $243 | — | $243 | 1.59% |
| MISSY A ARENHOLZ3 Filed as: MISSY ARENHOLZ | 403 W PROSPECT ST BOX 712 SHELL ROCK, IA 50670 | AFLAC | $207 | — | $207 | 1.36% |
| ANDREW THOMAS3 | 101 OLD COVE RD STE 114 LIVERPOOL, NY 13090 | AFLAC | $168 | — | $168 | 1.10% |
| JOHANNA R GRIFFIN3 Filed as: JOHANNA GRIFFIN | 341 WOODFORD DR MILLBROOK, AL 36054 | AFLAC | $134 | — | $134 | 0.88% |
| JENNIFER DICK3 | 891 BABCOCK LAKE ROAD PETERSBURG, NY 12138 | AFLAC | $107 | — | $107 | 0.70% |
| JOSEPH P CALARCO3 Filed as: JOSEPH CALARCO | PO BOX 130 AUBURN, NY 13021 | AFLAC | $93 | — | $93 | 0.61% |
| BRIAN K CHAMBERS3 Filed as: BRIAN CHAMBERS | 8 NIGHTWIND CT COLUMBUS, GA 31909 | AFLAC | $92 | — | $92 | 0.60% |
| THE TODD GROUP3 | 4409 BLAIR RIDGE RD CEDAR FALLS, IA 50613 | AFLAC | $84 | — | $84 | 0.55% |
| TYSON J BURTON3 Filed as: TYSON BURTON | 200 STATE ST STE 202Y CEDAR FALLS, IA 50613 | AFLAC | $70 | — | $70 | 0.46% |
| KEITH BELICH3 | 8408 TIMBER CREEK DR PIKE ROAD, AL 36064 | AFLAC | $45 | — | $45 | 0.29% |
| JOHN MACIAS JR3 | 950 N UNIVERSITY PARK LOOP RENO, NV 89512 | AFLAC | $42 | — | $42 | 0.28% |
| SAIC INC3 | 1639 BRADLEY PARK DR ST 500 BOX 358 COLUMBUS, GA 31904 | AFLAC | $37 | — | $37 | 0.24% |
| TAMMY STARNES3 | 1455 COUNTY ROAD 19 N PRATTVILLE, AL 36067 | AFLAC | $19 | — | $19 | 0.12% |
| KEVIN CURTIS3 | 401 RYLAND ST STE 204 RENO, NV 89502 | AFLAC | $18 | — | $18 | 0.12% |
| JENNIFER MACIAS3 | 950 N UNIVERSITY PARK LOOP RENO, NV 89512 | AFLAC | $15 | — | $15 | 0.10% |
| JOSHUA PAUL GROUP INC3 Filed as: JOSHUA TERRELL | 812 VENETIAN ISLES DR APT 1 LAKE PARK, FL 33403 | AFLAC | $13 | — | $13 | 0.09% |
| ERIC WILLIAMS3 | 2907 DALLAS DR CEDAR FALLS, IA 50613 | AFLAC | $12 | — | $12 | 0.08% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $7 | — | $7 | 0.05% |
| KACY A GRUENKEMEYER3 Filed as: KACY GRUENKEMEYER | 558 CLINGMANS LN CHATTANOOGA, TN 37419 | AFLAC | $6 | — | $6 | 0.04% |
| SCOTT R FRITCHER3 Filed as: SCOTT FRITCHER | 7408 LONGBOAT DR JOHNSTON, IA 50131 | AFLAC | $5 | — | $5 | 0.03% |
| AUSTIN J PETERSON3 Filed as: AUSTIN PETERSON | 11116 AURORA AVE URBANDALE, IA 50322 | AFLAC | $5 | — | $5 | 0.03% |
| MATTHEW D BUTLER3 Filed as: MATTHEW BUTLER | 123 CENTER PARK DR STE 102 KNOXVILLE, TN 37922 | AFLAC | $3 | — | $3 | 0.02% |
| AMY LUDWICK3 | 229 MCKAYS POINT PL WEST SACRAMENTO, CA 95605 | AFLAC | $2 | — | $2 | 0.01% |
| MICHAEL RHODD3 | 4160 GREEN VALLEY RD FAIRFIELD, CA 94534 | AFLAC | $2 | — | $2 | 0.01% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN LEE | 322 FARMHOUSE RD ELLERSLIE, GA 31807 | AFLAC | $2 | — | $2 | 0.01% |
| STAN A SHERLIN3 | 773 TOWNE LAKE DR MONTGOMERY, AL 36117 | AFLAC | $2 | — | $2 | 0.01% |
| LORA CARNES3 | 300 E 2ND ST STE 1320 RENO, NV 89501 | AFLAC | $1 | — | $1 | 0.01% |
| BERNARD BRAZEAU3 | 6705 GRIMES ST INDIANOLA, IA 50125 | AFLAC | $0 | — | $0 | 0.00% |
| HEATHER D SWANSON3 Filed as: HEATHER SWANSON | 115 SE BAYTREE DR WAUKEE, IA 50263 | AFLAC | $0 | — | $0 | 0.00% |
| ONEGROUP NY INC3 | 706 N CLINTON ST SYRACUSE, NY 13204 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | FIRST UNUM LIFE INSURANCE COMPANY | $630 | — | $630 | 5.00% |
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 | 398 | 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) | 398 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 251 | $3.3M |
| Dental | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 286 | $169K |
| Vision | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 286 | $169K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 384 | $103K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 138 | $97K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 138 | $97K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 251 | $3.3M |
| Other(4 contracts, 3 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 384 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 384 | — |
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.