| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHERIDAN BENEFITS LLC3 | 8685 SHERIDAN DR WILLIAMSVILLE, NY 14221 | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 6.82% |
| SHERIDAN BENEFITS LLC3 | 8685 SHERIDAN DR WILLIAMSVILLE, NY 14221 | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $363 | — | $363 | 5.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 5420 LBJ FREEWAY, STE 400 DALLAS, TX 75240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $194 | — | $194 | 3.83% |
| SHERIDAN BENEFITS LLC3 | 7 LIMESTONE DR WILLIAMSVILLE, NY 14221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $163 | — | $163 | 3.22% |
| SHERIDAN BENEFITS LLC3 | 7 LIMESTONE DR WILLIAMSVILLE, NY 14221 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.11% |
| SHERIDAN BENEFITS LLC3 | 7 LIMESTONE DR WILLIAMSVILLE, NY 14221 | FIRST UNUM LIFE INSURANCE COMPANY | $651 | — | $651 | 15.02% |
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 | 119 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD WNY | 211 | $858K |
| Dental | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 65 | $28K |
| Vision | UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 61 | $7K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 99 | $14K |
| Prescription drug | BLUE CROSS BLUE SHIELD WNY | 211 | $858K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 99 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.