| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY LLC | 361 DELAWARE AVE BUFFALO, NY 14202 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $16K | $16K | 3.54% |
| CARRIE A FAHEY3 | 5500 MAIN ST STE 260 WILLIAMSVILLE, NY 14221 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $1K | — | $1K | 1.61% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NORTHEAST LLC | 71 MONROE AVE, SUITE A PITTSFORD, NY 14534 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $924 | — | $924 | 1.03% |
| ROBERT F FAHEY3 | 5680 MAIN STREET WILLIAMSVILLE, NY 14226 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $106 | — | $106 | 0.12% |
| FAHEY, ROBERT, F3 | 89 BELVOIR WILLIAMSVILLE, NY 14221 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $79 | — | $79 | 0.09% |
| PLANNED BENEFITS INC3 | 73 REDDING ROAD, PO BOX 11 GEORGETOWN, CT 06829 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NORTHEAST LLC | 71 MONROE AVE, SUITE A PITTSFORD, NY 14534 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | — | $2K | 12.29% |
| CARRIE A FAHEY3 | 5500 MAIN ST STE 260 WILLIAMSVILLE, NY 14221 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | — | $2K | 9.78% |
| ROBERT F FAHEY3 | 89 BELVOIR WILLIAMSVILLE, NY 14221 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | — | $2K | 9.76% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY LLC | 361 DELAWARE AVE BUFFALO, NY 14202 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $876 | — | $876 | 4.54% |
| ROBERT F FAHEY3 | 5680 MAIN STREET WILLIAMSVILLE, NY 14221 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $40 | — | $40 | 0.21% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NORTHEAST LLC | 71 MONROE AVE, SUITE A PITTSFORD, NY 14534 | THE PAUL REVERE LIFE INSURANCE COMPANY | $190 | — | $190 | 1.48% |
| NEW ENGLAND EMPLOYEE BENEFITS CO3 Filed as: NEW ENGLAND LIFE INSURANCE CO | GRAGG BUILDING CHARLOTTE, NC 28277 | THE PAUL REVERE LIFE INSURANCE COMPANY | $38 | — | $38 | 0.30% |
| MJB FINANCIAL SERVICES INC3 Filed as: MJB FINANCIAL SERVICES, INC. | 75 MAPLE ROAD WILLIAMSVILLE, NY 14221 | THE PAUL REVERE LIFE INSURANCE COMPANY | $28 | — | $28 | 0.22% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NORTHEAST LLC | 71 MONROE AVE, SUITE A PITTSFORD, NY 14534 | HARTFORD LIFE COMPANY | $685 | — | $685 | 10.00% |
| SIGNATOR INSURANCE AGENCY INC3 | 197 CLARENDON ST C 8-8 BOSTON, MA 02116 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $155 | — | $155 | 3.00% |
| BUFLIFE AGENCY INC3 | 300 CORPORATE PKWY SUITE 200N AMHERST, NY 14226 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $103 | — | $103 | 2.00% |
| DESMON & KOHNSTAMM INC3 | 3635 GENESEE STREET, STE 200 BUFFALO, NY 14225 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $86 | — | $86 | 1.67% |
| JOHN T BARTON CLU & ASSOCIATES3 | 3 WOODPOINTE RUN WILLIAMSVILLE, NY 14221 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $86 | — | $86 | 1.67% |
| SPECIFIC SOLUTIONS INC3 | 475 INTERNATIONAL DR WILLIAMSVILLE, NY 14221 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $86 | — | $86 | 1.67% |
| HARRY E JACOBS3 | 6145 MCKINLEY RKWY, STE 22 HAMBURG, NY 14075 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $19 | — | $19 | 0.37% |
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 | 708 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 710 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNIVERA HEALTHCARE | 688 | $5.8M |
| Life insurance | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 359 | $439K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 359 | $439K |
| Long-term disability(6 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 359 | $566K |
| Prescription drug | UNIVERA HEALTHCARE | 485 | $5.8M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 359 | $445K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 688 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.