| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN, INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | EXCELLUS BLUECROSS BLUESHIELD | $107K | — | $107K | 21.03% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN, INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | EXCELLUS BLUECROSS BLUESHIELD | $14K | — | $14K | 3.47% |
| ROSE & KIERNAN INC3 | 99 TROY RD EAST GREENBUSH, NY 120611027 | FIRST UNUM LIFE INSURANCE COMPANY | $13K | — | $13K | 5.07% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN, INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 8.21% |
| ROSE & KIERNAN INC3 Filed as: ROSE & KIERNAN, INC | 99 TROY ROAD EAST GREENBUSH, NY 12061 | HM LIFE INSURANCE COMPNAY OF NEW YORK | $3K | — | $3K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 NONE | Claims processing Service code 12 | 165 COURT STREET ROCHESTER, NY 14647 | $310K |
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 | 673 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 72 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 745 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 463 | $507K |
| Dental | EXCELLUS BLUECROSS BLUESHIELD | 484 | $415K |
| Vision | HM LIFE INSURANCE COMPNAY OF NEW YORK | 378 | $33K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 548 | $247K |
| Short-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 548 | $282K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 548 | $247K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 463 | $507K |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 548 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 548 | — |
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.