| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONSILIARIUM GROUP LLC3 | 1250 PITTSFORD VICTOR RD BLDG 100 STE 110 PITTSFORD, NY 14534 | GUARDIAN | $8K | — | $8K | 2.69% |
| CONSILIARIUM GROUP LLC3 | 1250 PITTSFORD VICTOR RD BLDG 100 STE 110 PITTSFORD, NY 14534 | SYMETRA LIFE INSURANCE COMPANY | $9K | $940 | $10K | 11.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 TPA | Claims processing Service code 12 | — | $237K |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 377 | $314K |
| Vision | GUARDIAN | 377 | $314K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 479 | $87K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 479 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 479 | — |
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.