| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENV INSURANCE AGENCY LLC3 | 7789 OSWEGO RD LIVERPOOL, NY 13090 | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $0 | — | $0 | 0.00% |
| ENV INSURANCE AGENCY LLC3 Filed as: ENV INSURANCE AGENCY, LLC | 7789 OSWEGO RD LIVERPOOL, NY 13090 | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $1K | — | $1K | 3.75% |
| ENV INSURANCE AGENCY LLC3 Filed as: ENV INSURANCE AGENCY, LLC | 7789 OSWEGO RD LIVERPOOL, NY 13090 | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $1K | $0 | $1K | 3.75% |
| ENV INSURANCE AGENCY LLC3 | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | GUARDIAN | $2K | $1K | $3K | 14.72% |
| ENV INSURANCE AGENCY LLC3 | 7789 OSWEGO RD LIVERPOOL, NY 13090 | HM LIFE INSURANCE COMPANY | $182 | — | $182 | 10.01% |
| ENV INSURANCE AGENCY LLC3 | 7789 OSWEGO RD LIVERPOOL, NY 13090 | HARTFORD LIFE AND ACCIDENT | $126 | $5 | $131 | 12.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAUREEN LEIB EIN 16-1198780 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| BLITMAN & KING EIN 16-1047304 NONE | Legal; Direct payment from the plan Service code 29 | — | $46K |
| SUSANNE CLOUTE EIN 16-1198780 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $18K |
| BONADIO & CO., LLP EIN 16-1131146 NONE | Accounting (including auditing) Service code 10 | — | $14K |
| MANNING & NAPIER ADVISORS, LLC EIN 45-3328488 NONE | Direct payment from the plan; Investment management fees paid directly by plan Service code 50 | — | $11K |
| DEBRA POLITIS NONE | Consulting (general); Direct payment from the plan Service code 16 | 347 BUCKINGHAM AVE SYRACUSE, NY 13210 | $8K |
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 | 666 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 666 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(4 contracts, 4 carriers) | INDEPENDENT HEALTH | 640 | $82K |
| Vision | HM LIFE INSURANCE COMPANY | 24 | $2K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 14 | $1K |
| Prescription drug(3 contracts) | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 11 | $110K |
| Other(4 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 14 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 640 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.