| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | SUITE 325 235 MAGRATH DARBY BOULEVARD MT PLEASANT, SC 29464 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 3.92% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | WEST - SAN FRANCISCO PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 1.27% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY, LLC | 361 DELAWARE AVENUE BUFFALO, NY 14202 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 1.09% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 22113 FABCO RD WATERTOWN, NY 13601 | HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NEW YORK | $150 | — | $150 | 0.41% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: M&T INSURANCE AGENCY INC. | 285 DELAWARE AVE SUITE 4000 BUFFALO, NY 14202 | HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NEW YORK | $120 | — | $120 | 0.33% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: M&T INSURANCE AGENCY INC. | 285 DELAWARE AVE SUITE 4000 BUFFALO, NY 14202 | HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NEW YORK | $45 | — | $45 | 0.45% |
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 | 325 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 325 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NEW YORK | 8 | $80K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 325 | $267K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 325 | $267K |
| Prescription drug(3 contracts) | HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NEW YORK | 8 | $80K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 325 | $267K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 325 | — |
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."
No prospect flags tripped on this filing.