| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENV INSURANCE AGENCY LLC | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | HCC LIFE INSURANCE COMPANY | $32K | — | $32K | 15.00% |
| ENV INSURANCE AGENCY LLC | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | DELTA DENTAL OF NEW YORK | $30K | — | $30K | 25.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR NONE | Claims processing; Direct payment from the plan Service code 12 | 115 W. WAUSAU AVE. WAUSAU, WI 54401 | $794K |
| POMCO, INC. EIN 15-0381548 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $251K |
| MANNING & NAPIER ADVISORS, INC EIN 45-3328488 NONE | Investment management; Direct payment from the plan Service code 28 | — | $139K |
| KEENAN & ASSOCIATES EIN 95-2798626 NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $119K |
| DELTA DENTAL EIN 11-1980218 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $108K |
| US RX CARE NONE | Direct payment from the plan; Claims processing Service code 12 | 707 MIAMISBURG-CENTERVILLE RD 405 DAYTON, OH 45459 | $99K |
| BLITMAN AND KING EIN 16-1047304 NONE | Legal; Direct payment from the plan Service code 29 | — | $66K |
| TELEDOC, INC EIN 04-3705970 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $58K |
| M&T EIN 16-0538020 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $33K |
| BONADIO & CO, LLP EIN 16-1131146 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $30K |
| EXPRESS SCRIPTS NONE | Contract Administrator; Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $22K |
| O'SULLIVAN ASSOCIATES EIN 22-1837827 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $22K |
| DAVIS VISION EIN 11-3051991 NONE | Claims processing; Insurance services; Direct payment from the plan Service code 12 | — | $17K |
| SEGAL ADVISORS EIN 13-2646110 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $12K |
| KIANKA AND ZOLLO, CPA'S EIN 27-1242975 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $10K |
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 | 1,974 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 294 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW YORK | 2,308 | $117K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,901 | $211K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,308 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.