| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY BENEFITS GROUP, LLC | 361 DELAWARE AVE BUFFALO, NY 14202 | EXCELLUS BLUE CROSS BLUE SHIELD | $3K | — | $3K | 0.77% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY BENEFITS GROUP, LLC | 361 DELAWARE AVE BUFFALO, NY 14202 | SUN LIFE AND HEALTH INSURANCE COMPANY | $17K | — | $17K | 9.93% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY BENEFITS GROUP, LLC | 361 DELAWARE AVE BUFFALO, NY 14202 | SUN LIFE AND HEALTH INSURANCE COMPANY | $8K | — | $8K | 6.58% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY BENEFITS GROUP, LLC | 361 DELAWARE AVE BUFFALO, NY 14202 | GUARDIAN | $3K | $2K | $4K | 10.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 NONE | Claims processing Service code 12 | 165 COURT ST ROCHESTER, NY 14647 | $191K |
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 | 452 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 452 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 254 | $398K |
| Dental | EXCELLUS BLUE CROSS BLUE SHIELD | 254 | $398K |
| Vision | GUARDIAN | 214 | $40K |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY | 459 | $169K |
| Short-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY | 459 | $169K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY | 459 | $169K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 254 | $398K |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUE CROSS BLUE SHIELD | 254 | $398K |
| Other | SUN LIFE AND HEALTH INSURANCE COMPANY | 451 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 459 | — |
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."
Final-filing indicator set. Plan is winding down; don't waste sales effort here.