| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEVIN SMYTH3 | 110 LAMARCK DRIVE AMHERST, NY 14226 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 6.00% |
| LAWLEY BENEFITS GROUP LLC3 | 361 DELAWARE AVENUE BUFFALO, NY 14202 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $894 | $5K | 3.61% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 45 EAST AVE ROCHESTER, NY 14604 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $15 | $15 | 0.01% |
| KEVIN SMYTH3 | 110 LAMARCK DRIVE AMHERST, NY 14226 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 5.00% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY BENEFITS GROUP, LLC | 361 DELAWARE AVENUE BUFFALO, NY 14202 | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $379 | — | $379 | 0.52% |
| KEVIN SMYTH3 | 110 LAMARCK DRIVE AMHERST, NY 14226 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.00% |
| KEVIN SMYTH3 | 110 LAMARCK DRIVE AMHERST, NY 14226 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.30% |
| KEVIN SMYTH3 | 110 LAMARCK DRIVE AMHERST, NY 14226 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $620 | — | $620 | 5.00% |
| PETER NAYLON3 | 211 BRANTWOOD R AMHERST, NY 14226 | CIGNA GROUP INSURANCE | $464 | — | $464 | 15.01% |
| KEVIN SMYTH3 | 110 LAMARCK DRIVE AMHERST, NY 14226 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $105 | — | $105 | 4.98% |
| KEVIN SMYTH3 | 110 LAMARCK DRIVE AMHERST, NY 14226 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9 | — | $9 | 5.11% |
| KEVIN SMYTH3 | 110 LAMARCK DRIVE AMHERST, NY 14226 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1 | — | $1 | 7.14% |
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 | 277 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 360 | $139K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 389 | $137K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 304 | $32K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 359 | $152K |
| Prescription drug | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 18 | $72K |
| Other(5 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 363 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 389 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.