| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEDECKER-SAXE ASSOCIATES INC3 Filed as: DEDECKER SAXE ASSOCIATES INC | 334 DELAWARE AVE BUFFALO, NY 14202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $389K | — | $389K | 6.39% |
| M&T INSURANCE AGENCY INC3 Filed as: M&T INSURANCE AGENCY | 285 DELAWARE AVE BUFFALO, NY 14202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
| DEDECKER-SAXE ASSOCIATES INC3 Filed as: DEDECKER SAXE ASSOCIATES INC. | 334 DELAWARE AVE BUFFALO, NY 14202 | FIRST UNUM LIFE INSURANCE COMPANY | $111K | — | $111K | 2.85% |
| M&T INSURANCE AGENCY INC3 Filed as: M&T INSURANCE AGENCY | 285 DELAWARE BUFFALO, NY 14202 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| HUDSON SERVICING SOLUTIONS, LLC3 | 6 HARRISON STREET, 5TH FLOOR NEW YORK, NY 10013 | GERBER LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $3.6M |
| INDEPENDENT HEALTH EIN 16-1237733 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 511 FARBER LAKES DRIVE BUFFALO, NY 14221 | $1.9M |
| CVS CAREMARK EIN 05-0340626 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 1 CVS DRIVE WOONSOCKET, RI 02895 | $510K |
| DELTA DENTAL OF NEW YORK, INC EIN 11-1980218 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 575 MADISON AVE NEW YORK, NY 10022 | $403K |
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 | 16,340 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 16,340 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 9,612 | $127K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 20,102 | $6.1M |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 14,789 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 20,102 | — |
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.