| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAWLEY BENEFITS GROUP LLC3 | 361 DELAWARE AVENUE BUFFALO, NY 14202 | HARTFORD LIFE AND ACCIDENT | $35K | — | $35K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 23-7391136 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $2.5M |
| HEALTH MANAGEMENT CONCEPTS EIN 95-4146179 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $505K |
| LOOMIS COMPANY EIN 23-2238132 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $258K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $199K |
| SLEVIN & HART, PC EIN 52-1708613 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $194K |
| 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 | — | $128K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 RECORDKEEPING AND INFO | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $84K |
| SAMANTHA DERISO EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| MICHAEL CIANCAGLINI EIN 16-0915820 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $71K |
| PETER DECARLO CPA, PLLC EIN 51-0545975 UNION ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $57K |
| LISA GAETANO EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $54K |
| REGINA HEILAND EIN 16-0915820 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $49K |
| VICTORIA BATTISTA EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $47K |
| JEAN PAWELEK EIN 16-0915820 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $47K |
| MARYBETH REWKOWSKI EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $45K |
| RENE MURPHY-JOHNSON EIN 16-0915820 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $44K |
| NADINE CAMPOLA EIN 16-0915820 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $42K |
| CHERYL GRAZIANO EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $41K |
| MARIANNE YOUNG EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $41K |
| DAVIS VISION EIN 11-3051991 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $38K |
| PHIL BRUZZESE EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $37K |
| PAMELA MAZZATTI EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $35K |
| JOSEPH BATTISTA EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $29K |
| BRIAN FREEMAN EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $29K |
| EMILIA D'AMBRO EIN 16-0915820 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $22K |
| WHIP HEALTH EIN 32-0412653 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $12K |
| NORTHERN TRUST COMPANY EIN 36-1561860 INVESTMENT CUSTODIAN | Custodial (securities); Direct payment from the plan Service code 19 | — | $10K |
| INVESTMENT PERFORMANCE SERVICES EIN 58-1645832 INVESTMENT CONSULTANT | Investment advisory (plan); Direct payment from the 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 | 10,130 | 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) | 10,130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 14,026 | $691K |
| Other | HARTFORD LIFE AND ACCIDENT | 14,026 | $691K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 14,026 | — |
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.