| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONSILIARIUM GROUP LLC3 Filed as: CONSILIARIUM GROUP | 1250 PITTSFORD VICTOR RD BLDG 100 STE 110 PITTSFORD, NY 14534 | EXCELLUS BLUECROSS BLUESHIELD | $16K | — | $16K | 6.43% |
| CONAILIARIUM GROUP3 | 1250 PITTSFORD VICTOR RD BLDG 100 STE 110 PITTSFORD, NY 14534 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 8.99% |
| IMG5 | 2960 N MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $64 | $64 | 0.05% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE | 122 SOUTH MICHIGAN AVE CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $11 | $11 | 0.01% |
| CONSILIARIUM GROUP LLC3 | 1250 PITTSFORD VICTOR RD BLDG 100 STE 110 PITTSFORD, NY 14534 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $1K | $3K | 13.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 TPA - MEDICAL | Claims processing Service code 12 | — | $153K |
| EXCELLUS BLUE CROSS BLUESHIELD EIN 15-0329043 TPA - DENTAL | Claims processing Service code 12 | — | $18K |
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 | 345 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 350 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 186 | $24K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 345 | $126K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 345 | $126K |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUECROSS BLUESHIELD | 235 | $249K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 345 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 345 | — |
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.