| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOESEL-SCHAAF INSURANCE AGENCY INC3 Filed as: LOESEL SCHAAF INSURANCE AGENCY | 3537 WEST 12TH STREET ERIE, PA 16505 | DELTA DENTAL OF NEW YORK | $3K | — | $3K | 5.00% |
| LOESEL-SCHAAF INSURANCE AGENCY INC3 Filed as: LOESEL SCHAAF INSURANCE AGENCY, INC | 3537 WEST 12TH STREET ERIE, PA 16505 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 13.50% |
| LOESEL-SCHAAF INSURANCE AGENCY INC3 Filed as: LOESEL SCHAAF INSURANCE AGENCY | 3537 WEST 12TH STREET ERIE, PA 16505 | LINCOLN LIFE AND ANNUITY OF NEW YORK | $2K | — | $2K | 10.82% |
| LOESEL-SCHAAF INSURANCE AGENCY INC3 Filed as: LOESEL SCHAAF INSURANCE AGENCY | 3537 WEST 12TH STREET ERIE, PA 16505 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $934 | — | $934 | 12.94% |
| LOESEL SCHAFF INSURANCE AGENCY3 Filed as: LOESEL SCHAFF INSURANCE AGENCY, INC | 3537 WEST 12TH STREET ERIE, PA 16505 | HEALTHNOW NEW YORK, INC. DBA BLUE CROSS BLUE SHIELD OF WESTERN NY | $27K | — | $27K | — |
| CHRISTOPHER BARBER3 Filed as: CHRISTOPHER J METZGER | 1121 WALT WHITMAN ROAD MELVILLE, NY 11747 | HEALTHNOW NEW YORK, INC. DBA BLUE CROSS BLUE SHIELD OF WESTERN NY | $6K | — | $6K | — |
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 | 425 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 425 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEW YORK | 148 | $63K |
| Life insurance(2 contracts, 2 carriers) | LINCOLN LIFE AND ANNUITY OF NEW YORK | 425 | $22K |
| Long-term disability | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 138 | $25K |
| Prescription drug | HEALTHNOW NEW YORK, INC. DBA BLUE CROSS BLUE SHIELD OF WESTERN NY | 312 | $0 |
| Other | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 171 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 425 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.