| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEY INSURANCE & BENEFIT SERVICES3 | 6950 S TRANSIT ROAD LOCKPORT, NY 14094 | AETNA | $23K | — | $23K | 4.01% |
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD SUITE 100 ROCHESTER, NY 14623 | EXCELLUS BLUE CROSS BLUE SHIELD | $19K | — | $19K | 3.76% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN EMPIRE STATE | 500 PLUM STREET SUITE 200 SYRACUST, NC 13204 | EXCELLUS BLUE CROSS BLUE SHIELD | $4K | — | $4K | 0.72% |
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD SUITE 100 ROCHESTER, NY 14623 | EXCELLUS BLUE CROSS BLUE SHIELD | $3K | — | $3K | 9.41% |
| 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 | $509 | — | $509 | 1.43% |
| KEY INSURANCE & BENEFIT SERVICES3 | 126 N SALINA ST #600 SYRACUSE, NY 13202 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $905 | — | $905 | 7.45% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66995 VIRGINIA BEACH, VA 23466 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $773 | — | $773 | 6.37% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $143 | — | $143 | 1.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 1215 MANOR DR STE 200 MECHANICSBURG, PA 17055 | HM LIFE INSURANCE COMPANY OF NEW YORK | $532 | — | $532 | 5.23% |
| KEY INSURANCE & BENEFIT SERVICES3 Filed as: KEY INSURANCE AND BENEFIT SERVICES | 1215 MANOR DRIVE SUITE 200 MECHANICSBURG, PA 17055 | HM LIFE INSURANCE COMPANY OF NEW YORK | $397 | — | $397 | 3.90% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 4104 VESTAL AVE VESTAL, NY 13850 | HM LIFE INSURANCE COMPANY OF NEW YORK | $91 | — | $91 | 0.90% |
| KEY INSURANCE & BENEFIT SERVICES3 Filed as: KEY INSURANCE & BENEFIT SVCS INC | 126 N SALINA ST #600 SYRACUSE, NY 13202 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $644 | — | $644 | 7.84% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66995 VIRGINIA BEACH, VA 23466 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $490 | — | $490 | 5.97% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $98 | — | $98 | 1.19% |
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA | 216 | $1.1M |
| Dental(2 contracts, 2 carriers) | AETNA | 216 | $604K |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 95 | $10K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 80 | $13K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 55 | $12K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 40 | $8K |
| Prescription drug(2 contracts, 2 carriers) | AETNA | 216 | $1.1M |
| Other | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 80 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 216 | — |
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."
No prospect flags tripped on this filing.