| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | AETNA | $53K | — | $53K | 3.49% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN EMPIRE STATE | 500 PLUM ST. STE. 200 SYRACUSE, NC 13204 | EXCELLUS BLUE CROSS BLUE SHIELD | $31K | — | $31K | 4.33% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | DELTA DENTAL OF NEW YORK | $3K | — | $3K | 4.09% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $6K | — | $6K | 14.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 500 PLUM ST SUITE 200 SYRACUSE, NE 13204 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $3K | $5K | 15.32% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | AETNA | $2K | — | $2K | 14.33% |
| BRIAN MCLAUCHLAN3 | 303 FOREST DR NORTH SYRACUSE, NY 13212 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $2K | $4K | 26.44% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 401 S MAIN ST NORTH SYRACUSE, NY 13212 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3K | — | $3K | 18.99% |
| SUSAN SMITH3 | 1216 LANDRUSH WAY BADLWINSVILLE, NY 13027 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $178 | $1K | 9.16% |
| MICHAEL L O'DONNELL3 | 133 HAZELHURST AVE NORTH SYRACUSE, NY 13212 | THE PAUL REVERE LIFE INSURANCE COMPANY | $558 | $471 | $1K | 6.93% |
| JACQUELINE RENEE JACKSON3 | LEYLAND CYPRESS COURT ELGIN, SC 29045 | THE PAUL REVERE LIFE INSURANCE COMPANY | $590 | $53 | $643 | 4.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFETIME BENEFITS SOLUTIONS, INC EIN 16-1171765 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | 115 CONTINUUM DRIVE LIVERPOOL, NY 13088 | $5K |
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 | 296 | 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) | 296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA | 397 | $2.2M |
| Dental | DELTA DENTAL OF NEW YORK | 248 | $65K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 229 | $32K |
| Life insurance | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 296 | $42K |
| Short-term disability | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 296 | $42K |
| Long-term disability | AETNA | 238 | $17K |
| Prescription drug(2 contracts, 2 carriers) | AETNA | 397 | $2.2M |
| Other(2 contracts, 2 carriers) | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 296 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 397 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.