| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | PO BOX 4557 NEW YORK, NY 10249 | HEALTHNOW NEW YORK INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $38K | — | $38K | 2.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC | 200 LIBERTY STREET NEW YORK 10281 NEW YORK, NY 10281 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 17.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NY INC. | 300 AIRBORNE PARKWAY BUFFALO, NY 14225 | HM LIFE INSURANCE COMPANY OF NEW YORK | $1K | — | $1K | 10.00% |
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 | 177 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHNOW NEW YORK INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 667 | $1.9M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 225 | $20K |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 142 | $12K |
| Other | HEALTHNOW NEW YORK INC. DBA BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 667 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 667 | — |
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.