| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSEPH L DILEO3 | 300 CORPORATE PARKWAY SUITE 216N AMHERST, NY 142261259 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $204 | $526 | $730 | 2.57% |
| DANIEL KLUN3 | 37 FRANKLIN STREET SUITE 600 BUFFALO, NY 14202 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $556 | — | $556 | 1.96% |
| MARK B. KOSTRZESKI3 Filed as: MARK B KOSTRZEWSKI | 120 WEST TUPPER ST SUITE 200 BUFFALO, NY 14201 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $6 | — | $6 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PPS PENSION SERVICES, INC. EIN 16-1062503 REORDKEEPER | Plan Administrator; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $13K |
| GLOBAL RETIREMENT PARTNERS LLC EIN 47-1411118 INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | — | $12K |
| MASSACHUSETTS MUTUAL LIFE INSURANCE EIN 04-1590850 CONTRACT ADMINISTRATOR | Investment management fees paid indirectly by plan; Other investment fees and expenses; Other insurance wrap fees; Soft dollars commissions; Distribution (12b-1) fees; Sub-transfer agency fees; Other services; Recordkeeping fees; Float revenue Service code 49 | — | $2K |
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 | 73 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 52 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | 28 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 28 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.