| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAWLEY BENEFITS GROUP LLC3 | 361 DELAWARE AVENUE BUFFALO, NY 14202 | HARTFORD LIFE INSURANCE CO. | $30K | $8K | $38K | 6.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS / BLUE SHIELD EIN 23-7391136 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $2.7M |
| LIFETIME BENEFIT SOLUTIONS, INC. EIN 16-1171765 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $280K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 RECORDKEEPING AND INFO | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $230K |
| UFCW DISTRICT UNION LOCAL ONE EIN 15-0559586 LABOR UNION | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $182K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $154K |
| SLEVIN & HART, PC EIN 52-1708613 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $127K |
| EMAP HEALTH MANAGEMENT CENTER EIN 95-4146179 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $124K |
| MICHAEL CIANCAGLINI EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $112K |
| STAT HEALTH SERVICES, INC. EIN 27-0549176 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $96K |
| KAREN GILOT EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| SAMANTHA DERISO EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| ANDREA GOLDBERGER EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $76K |
| PETER DECARLO CPA, PLLC EIN 51-0545975 UNION ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $63K |
| JEAN PAWELEK EIN 16-0915820 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $47K |
| REGINA HEILAND EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $46K |
| MARYBETH REWKOWSKI EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $45K |
| KIM CARCONE EIN 16-0915820 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $43K |
| DAVIS VISION EIN 11-3051991 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $40K |
| VICTORIA BATTISTA EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $39K |
| MARIANNE YOUNG EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $38K |
| RENE MURPHY-JOHNSON EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $36K |
| PHIL BRUZZESE EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $34K |
| PAMELA MAZZATTI EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $31K |
| CHERYL GRAZIANO EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $31K |
| CHARTWELL INVESTMENT PARTNERS EIN 23-2891243 INVESTMENT MANAGER | Investment management; Direct payment from the plan Service code 28 | — | $29K |
| JOSEPH BATTISTA EIN 16-0915820 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $29K |
| DIANE BLACK EIN 16-0915820 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $29K |
| NADINE CAMPOLA EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $27K |
| COMMERCE TRUST COMPANY EIN 48-0962626 NONE | Investment management; Direct payment from the plan Service code 28 | — | $26K |
| LISA GAETANO EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $26K |
| BRIAN FREEMAN EIN 16-0915820 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $26K |
| EMILIA D'AMBRO EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $24K |
| INVESTMENT PERFORMANCE SERVICES EIN 58-1645832 INVESTMENT CONSULTANT | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $20K |
| NORTHERN TRUST COMPANY EIN 36-1561860 INVESTMENT CUSTODIAN | Custodial (securities); Direct payment from the plan Service code 19 | — | $10K |
| CATAMARAN / NMHC EIN 11-2581812 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $10K |
| KARYONA CITTADINO EIN 16-6184130 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $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 | 11,131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 11,131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE INSURANCE CO. | 15,344 | $590K |
| Other | HARTFORD LIFE INSURANCE CO. | 15,344 | $590K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,344 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
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.