| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN EMPIRE STATE | 500 PLUM STREET SUITE 200 SYRACUSE, NY 13204 | EXCELLUS BLUE CROSS BLUE SHIELD | $17K | — | $17K | 2.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | EXCELLUS BLUE CROSS BLUE SHIELD | $14K | — | $14K | 2.13% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC. | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $7K | $13K | 10.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.45% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC. | 500 PLUM ST. SUITE 200 SYRACUSE, NY 13204 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $945 | $231 | $1K | 7.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $810 | — | $810 | 5.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC. | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | VISION SERVICE PLAN | $678 | — | $678 | 7.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $362 | — | $362 | 4.24% |
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 | 136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 91 | $655K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 135 | $125K |
| Vision | VISION SERVICE PLAN | 72 | $9K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 135 | $125K |
| Short-term disability | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | 136 | $16K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 135 | $125K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 91 | $655K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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.