| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS M. HANLEY3 Filed as: THOMAS M. HANLEY, HANLEY ASSOCIATES | 108 W. JEFFERSON STREET SYRACUSE, NY 13202 | EXCELLUS BLUECROSS BLUESHIELD | $17K | — | $17K | 3.88% |
| THOMAS M. HANLEY3 | 200 WOODLAWN TERRACE SYRACUSE, NY 13203 | AETNA LIFE INSURANCE CO. | $3K | — | $3K | 4.57% |
| MICHELLE ALLETZHAUSER3 | 316 SOUTH MAIN STREET NORTH SYRACUSE, NY 13212 | MVP HEALTH CARE | $166 | — | $166 | 2.10% |
| THOMAS M. HANLEY3 Filed as: THOMAS M. HANLEY, HANLEY ASSOCIATES | 108 W. JEFFERSON STREET SYRACUSE, NY 13202 | MVP HEALTH CARE | $164 | — | $164 | 2.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| POMCO INC. EIN 15-0381548 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $88K |
| BLITMAN & KING, LLP EIN 16-1047304 NONE | Legal; Direct payment from the plan Service code 29 | — | $42K |
| M&T TRUST COMPANY EIN 16-6265706 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $42K |
| IRON WORKERS UNION LOCAL NO. 60 EIN 15-0347910 ADMINISTRATIVE | Contract Administrator; Direct payment from the plan Service code 13 | — | $31K |
| DERMODY, BURKE & BROWN, CPAS, LLC EIN 01-0723685 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $11K |
| RICHARD W. HEIMERMAN, CPA, PC EIN 16-1537589 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $7K |
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 | 219 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 185 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 404 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EXCELLUS BLUECROSS BLUESHIELD | 3 | $436K |
| Life insurance | AETNA LIFE INSURANCE CO. | 177 | $67K |
| Short-term disability | AETNA LIFE INSURANCE CO. | 177 | $67K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 3 | $428K |
| Other | AETNA LIFE INSURANCE CO. | 177 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.