| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN BENEFITS GROUP, INC.3 | 2914 PINE AVE NIAGARA FALLS, NY 14301 | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $152K | — | $152K | 3.00% |
| ROBERT BERGMAN3 | 123 KILBURN DRIVE CHERRY HILL, NJ 08003 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $12K | — | $12K | 6.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MANNING & NAPIER EIN 16-0995736 INVESTMENT MANAGER | Investment management Service code 28 | — | $96K |
| MICHAEL FREUND EIN 16-0841423 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $65K |
| BLITMAN & KING, LLP EIN 16-1047304 ATTORNEY | Legal Service code 29 | — | $61K |
| LEEANN KEZMAN EIN 16-0841426 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| M. RENEE WOELFEL EIN 16-0841426 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| DEANNA WRAZEN EIN 16-0841423 EMPLOYEE | Employee (plan) Service code 30 | — | $57K |
| ALICE RINK EIN 16-0841423 EMPLOYEE | Employee (plan) Service code 30 | — | $56K |
| BONADIO & CO., LLP EIN 16-1131146 ACCOUNTANT | Accounting (including auditing) Service code 10 | — | $48K |
| KATHLEEN COHEN EIN 16-0841423 EMPLOYEE | Employee (plan) Service code 30 | — | $35K |
| JBM COMPUTER CONSULTANTS EIN 16-1173118 CONSULTANT | Consulting (general) Service code 16 | — | $31K |
| O'SULLIVAN ASSOCIATES EIN 22-1837827 ACTUARY | Actuarial Service code 11 | — | $22K |
| M&T INVESTMENT GROUP EIN 16-0538020 INVESTMENT CUSTODIAN | Custodial (securities) Service code 19 | — | $13K |
| MARCO CONSULTING GROUP EIN 35-3555078 INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | — | $9K |
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 | 920 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 114 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,040 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HEALTHNOW NEW YORK, INC. DBA BLUECTOSS BLUESHIELD OF WESTERN NEW YORK | 85 | $16K |
| Vision | HEALTHNOW NEW YORK, INC. DBA BLUECTOSS BLUESHIELD OF WESTERN NEW YORK | 85 | $16K |
| Life insurance | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 779 | $190K |
| Prescription drug(3 contracts, 2 carriers) | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 1,046 | $5.3M |
| Other | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 1,046 | $5.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,046 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.