| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 595 STEWART AVE FLOOR 7 GARDEN CITY, NY 11530 | SYMETRA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.62% |
| 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 | $748 | — | $748 | 8.06% |
| DEBRA PARKER3 | 20 BOWEN ST AUBURN, NY 13021 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $137 | — | $137 | 1.48% |
| LAURA ANNE CALARCO3 Filed as: LAURA CALARCO | 340 HORSE CREEK DR APT 208 NAPLES, FL 34110 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $51 | $56 | $107 | 1.15% |
| NICHOLAS CALARCO3 | 162 YORK ST AUBURN, NY 13021 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $59 | $7 | $66 | 0.71% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $44 | — | $44 | 0.47% |
| JOSEPH P CALARCO3 Filed as: JOSEPH CALARCO | PO BOX 130 AUBURN, NY 13021 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $34 | $7 | $41 | 0.44% |
| SHAWN DALY3 | 2287 CENTER RD SCIPIO CENTER, NY 13147 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $25 | — | $25 | 0.27% |
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON, INC | PO BOX 4743 SYRACUSE, NY 13221 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $22 | — | $22 | 0.24% |
| KELLY A IRVINE3 | 15801 WHITE ORCHID LN FORT MYERS, FL 33908 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $13 | — | $13 | 0.14% |
| BRENDAN MCCARTHY AND CREW INC3 | 39 SAGINAW DR STE 2 ROCHESTER, NY 14623 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $3 | — | $3 | 0.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | PO BOX 745808 ATLANTA, GA 30374 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $333 | $91 | $424 | 4.90% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | PO BOX 745808 ATLANTA, GA 30374 | PROVIDENT LIFE CASUALTY INSURANCE COMPANY | $705 | — | $705 | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 500 PLUM ST SUITE 200 SYRACUSE, NY 13204 | PROVIDENT LIFE AND CASUALTY INSURANCE | $681 | $136 | $817 | 12.00% |
| 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 | 146 | 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) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | PROVIDENT LIFE AND CASUALTY INSURANCE | 66 | $7K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 146 | $25K |
| Other(6 contracts, 5 carriers) | SYMETRA LIFE INSURANCE COMPANY | 155 | $52K |
| 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.