| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS | 1900 RIDGE RD. WEST SENECA, NY 14224 | HEALTHNOW NEW YORK DBA BLUECROSS BLUESHIELD OF WNY | $31K | — | $31K | 2.70% |
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS, INC. | 1900 RIDGE ROAD WEST SENECA, NY 14224 | HEALTHNOW NEW YORK DBA BLUECROSS BLUESHIELD OF WNY | $8K | — | $8K | 3.28% |
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS, INC | 1900 RIDGE ROAD WEST SENECA, NY 14224 | HEALTHNOW NEW YORK DBA BLUECROSS BLUESHIELD OF WNY | $3K | — | $3K | 2.97% |
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS INC | 1900 RIDGE RD WEST SENECA, NY 142243332 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 5.51% |
| PAUL ROBILLARD AND ASSOCIATES3 Filed as: PAUL ROBILLARD & ASSOCIATES INC | 4536 MAIN STREET SUITE 100 AMHERST, NY 142263828 | COMPANION LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS, INC. | 1900 RIDGE ROAD WEST SENECA, NY 14224 | HEALTHNOW NEW YORK DBA BLUECROSS BLUESHIELD OF WNY | $1K | — | $1K | 4.06% |
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS, INC | 1900 RIDGE ROAD WEST SENECA, NY 14224 | HEALTHNOW NEW YORK DBA BLUECROSS BLUESHIELD OF WNY | $760 | — | $760 | 6.21% |
| PAUL ROBILLARD AND ASSOCIATES3 Filed as: PAUL ROBILLARD & ASSOCIATES INC | 4536 MAIN STREET SUITE 100 AMHERST, NY 142263828 | MUTUAL OF OMAHA INSURANCE COMPANY | $506 | — | $506 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILLIAM GRACE EIN 16-0776158 FUND ADMINISTRATOR | Employee (plan) Service code 30 | — | $136K |
| GINA ALLEN EIN 16-0776158 EMPLOYEE | Employee (plan) Service code 30 | — | $76K |
| MARIA MONTANTE EIN 16-0776158 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| ARCARA ZUCARELLI LENDA & ASSOCIATES EIN 47-1793720 NONE | Accounting (including auditing) Service code 10 | — | $42K |
| JBM COMPUTER CONSULTANTS EIN 16-1173118 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $19K |
| LIPSITZ GREEN SCIME CAMBRIA EIN 16-0905097 NONE | Legal Service code 29 | — | $18K |
| O'SULLIVAN ASSOCIATES EIN 22-1837827 NONE | Actuarial Service code 11 | — | $10K |
| MORGAN STANLEY EIN 26-4310632 | Direct payment from the plan; Other investment fees and expenses; Other fees; Other services; Securities brokerage; Securities brokerage commissions and fees; Investment advisory (plan) Service code 27 | — | $6K |
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 | 389 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 155 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 544 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $41K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 196 | $36K |
| Prescription drug(6 contracts) | HEALTHNOW NEW YORK DBA BLUECROSS BLUESHIELD OF WNY | 164 | $1.7M |
| Other(3 contracts, 2 carriers) | HEALTHNOW NEW YORK DBA BLUECROSS BLUESHIELD OF WNY | 196 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.