| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON INC. | 231 SALINA MEADOWS SYRACUSE, NY 13212 | EXCELLUS BLUECROSS BLUESHIELD | $49K | — | $49K | 4.12% |
| ACRISURE LLC3 Filed as: HAYLOR FREYER & COON INC. | 231 SALINA MEADOWS SYRACUSE, NY 13221 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $3K | $14K | 6.02% |
| ACRISURE LLC3 Filed as: HAYLOR FREYER & COON, INC. | 231 SALINA MEADOWS PARKWAY SYRACUSE, NY 13212 | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | $4K | — | $4K | 8.00% |
| MEDICAL GROUP INSURANCE SERVICES3 | 1849 WEST NORTH TEMPLE SALT LAKE CITY, UT 84116 | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | — | $90 | $90 | 0.17% |
| ACRISURE LLC3 Filed as: HAYLOR FREYER & COON, INC. | 231 SALINA MEADOWS PARKWAY SYRACUSE, NY 13212 | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | $3K | — | $3K | 8.00% |
| MEDICAL GROUP INSURANCE SERVICES3 | 1849 WEST NORTH TEMPLE SALT LAKE CITY, UT 84116 | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | — | $90 | $90 | 0.24% |
| ACRISURE LLC3 Filed as: HAYLOR FREYER & COON INC. | 231 SALINA MEADOWS P.O. BOX 4743 SYRACUSE, NY 132214743 | UNUM LIFE INSURANCE COMPANY | $2K | $236 | $2K | 16.68% |
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 | 266 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 164 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $233K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $233K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $233K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | 266 | $51K |
| Long-term disability | SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK | 125 | $53K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 164 | $1.2M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.