| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS, INC. | 301 OHIO STREET, SUITE 250 BUFFALO, NY 14204 | BLUECROSS BLUESHIELD OF WNY | — | — | $0 | 0.00% |
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS, INC. | 301 OHIO STREET, SUITE 250 BUFFALO, NY 14204 | BLUECROSS BLUESHIELD OF WNY | $7K | — | $7K | 3.18% |
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS, INC. | 301 OHIO STREET, SUITE 250 BUFFALO, NY 14204 | BLUECROSS BLUESHIELD OF WNY | $3K | — | $3K | 2.86% |
| PAUL ROBILLARD AND ASSOCIATES3 Filed as: PAUL ROBILLARD & ASSOCIATES INC | 4536 MAIN STREET SUITE 100 AMHERST, NY 142263828 | COMPANION LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS, INC. | 301 OHIO STREET, SUITE 250 BUFFALO, NY 14204 | BLUECROSS BLUESHIELD OF WNY | $1K | — | $1K | 3.85% |
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS INC | 301 OHIO STREET, 250 BUFFALO, NY 142042514 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $30 | $2K | 6.38% |
| EMPLOYEE BENEFIT CONCEPTS INC.3 Filed as: EMPLOYEE BENEFIT CONCEPTS, INC. | 301 OHIO STREET, SUITE 250 BUFFALO, NY 14204 | BLUECROSS BLUESHIELD OF WNY | $880 | — | $880 | 5.31% |
| PAUL ROBILLARD AND ASSOCIATES3 Filed as: PAUL ROBILLARD & ASSOCIATES INC | 4536 MAIN STREET SUITE 100 AMHERST, NY 142263828 | MUTUAL OF OMAHA INSURANCE COMPANY | $423 | — | $423 | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILLIAM GRACE EIN 16-0776158 FUND ADMINISTRATOR | Employee (plan) Service code 30 | — | $167K |
| GINA APPOLONEY EIN 16-0776158 EMPLOYEE | Employee (plan) Service code 30 | — | $78K |
| MARIA MONTANTE EIN 16-0776158 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| ARCARA ZUCARELLI LENDA & ASSOCIATES EIN 47-1793720 NONE | Accounting (including auditing) Service code 10 | — | $50K |
| LIPSITZ GREEN SCIME & CAMBRIA EIN 16-0905097 NONE | Legal Service code 29 | — | $22K |
| JBM COMPUTER CONSULTANTS, INC. EIN 16-1173118 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $17K |
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 | 425 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 141 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 566 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 149 | $27K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 166 | $35K |
| Prescription drug(6 contracts) | BLUECROSS BLUESHIELD OF WNY | 113 | $1.3M |
| Other(7 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF WNY | 166 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.