| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE | 595 STEWART AVE FL 7 GARDEN CITY, NY 11530 | SYMETRA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.62% |
| BROWN & BROWN INSURANCE SERVICES3 | PO BOX 745808 ATLANTA, GA 30374 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $354 | $84 | $438 | 4.48% |
| BROWN & BROWN INSURANCE SERVICES3 | PO BOX 745808 ATLANTA, GA 30374 | PROVIDENT LIFE CASUALTY INSURANCE COMPANY | $811 | $59 | $870 | 10.76% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $690 | — | $690 | 8.69% |
| DEBRA M PARKER3 Filed as: DEBRA PARKER | 20 BOWEN ST AUBURN, NY 13021 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $129 | — | $129 | 1.62% |
| SHAWN DALY3 | 2287 CENTER RD SCIPIO CENTER, NY 13147 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $28 | — | $28 | 0.35% |
| NICHOLAS CALARCO3 | 120 E WASHINGTON ST STE 822 SYRACUSE, NY 13202 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $26 | — | $26 | 0.33% |
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON, INC | PO BOX 4743 SYRACUSE, NY 13221 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $19 | — | $19 | 0.24% |
| JOSEPH P CALARCO3 Filed as: JOSEPH CALARCO | PO BOX 130 AUBURN, NY 13021 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $14 | — | $14 | 0.18% |
| KELLY A IRVINE3 | 15801 WHITE ORCHID LN FORT MYERS, FL 33908 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $13 | — | $13 | 0.16% |
| LAURA ANNE CALARCO3 Filed as: LAURA CALARCO | 340 HORSE CREEK DR APT 208 NAPLES, FL 34110 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $1 | — | $1 | 0.01% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $1 | — | $1 | 0.01% |
| BROWN & BROWN INSURANCE SERVICES3 | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | PROVIDENT LIFE AND CASUALTY INSURANCE | $758 | $65 | $823 | 10.86% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | FIRST UNUM LIFE INSURANCE COMPANY | $21 | — | $21 | 14.58% |
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 | 153 | 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) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | PROVIDENT LIFE AND CASUALTY INSURANCE | 68 | $8K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 153 | $24K |
| Other(6 contracts, 5 carriers) | SYMETRA LIFE INSURANCE COMPANY | 155 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 155 | — |
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.