| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN BENEFITS GROUP, INC.3 Filed as: CROWN BENEFITS GROUP INC. | 2914 PINE AVENUE NIAGARA FALLS, NY 14301 | SIERRA HEALTH AND LIFE INSURANCE COMPANY | $39K | — | $39K | 3.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DEBRA KORPOLINSKI EIN 16-1561710 EMPLOYEE | Employee (plan) Service code 30 | — | $158K |
| JANICE MASLEN EIN 16-1561710 EMPLOYEE | Employee (plan) Service code 30 | — | $93K |
| BARBARA ZELLNER EIN 16-1561710 EMPLOYEE | Employee (plan) Service code 30 | — | $81K |
| BLITMAN AND KING, LLP EIN 16-1047304 NONE | Legal Service code 29 | — | $78K |
| THERESA RAYCHEL EIN 16-1561710 EMPLOYEE | Employee (plan) Service code 30 | — | $77K |
| CROWN BENEFITS GROUP, INC. EIN 16-1580963 NONE | Consulting fees Service code 70 | — | $60K |
| ARCARA ZUCARELLI LENDA & STRAKA CPA EIN 47-1793720 NONE | Accounting (including auditing) Service code 10 | — | $39K |
| UBS FINANCIAL SERVICES EIN 13-2638166 NONE | Other fees; Investment advisory (plan) Service code 27 | — | $11K |
| JBM COMPUTER CONSULTANTS EIN 16-1173118 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $11K |
| HALLETT ASSOCIATES INC. EIN 25-1592340 NONE | Actuarial Service code 11 | — | $6K |
| M&T BANK EIN 16-0538020 NONE | Custodial (securities); Investment management Service code 19 | — | $4K |
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 | 870 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 484 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,354 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIERRA HEALTH AND LIFE INSURANCE COMPANY | 467 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,354 | $271K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,354 | $271K |
| Prescription drug(2 contracts) | HEALTHNOW NEW YORK, INC. DBA BLUE CROSS BLUE SHIELD OF WNY | 2,430 | $11.6M |
| Other(3 contracts, 2 carriers) | HEALTHNOW NEW YORK, INC. DBA BLUE CROSS BLUE SHIELD OF WNY | 2,430 | $11.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,430 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.