| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: AP BENEFIT ADVISORS LLC DBA ENV INS | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | EXCELLUS BLUE CROSS BLUE SHIELD | $3K | — | $3K | 6.93% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS HEALTH PLAN INC EIN 15-0329043 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 165 COURT STREET ROCHESTER, NY 14647 | $272K |
| BLITMAN & KING LLP EIN 16-1047304 ATTORNEY | Legal Service code 29 | 443 NORTH FRANKLIN ST SYRACUSE, NY 13204 | $25K |
| D'ARCANGELO & CO., LLP EIN 13-2550103 AUDITOR | Accounting (including auditing) Service code 10 | 120 LOMOND COURT UTICA, NY 13502 | $22K |
| C.S. MCKEE LP EIN 25-1900687 INVESTMENT MANAGER | Investment management Service code 28 | ONE GATEWAY CENTRE PITTSBURGH, PA 15222 | $16K |
| BOLTON PARTNERS NORTHEAST INC EIN 27-3666661 ACTUARY | Actuarial Service code 11 | 2277 STATE HYW 3 SU 409 TRENTON, NJ 08690 | $13K |
| HIGHTOWER ADVISORS MORGIA GRP EIN 36-4500709 INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | 151 MULLIN ST WATERTOWN, NY 13601 | $8K |
| INTEGRA CONSULTING, INC EIN 16-1600723 NONE | Other services Service code 49 | 9621 SMITH RD WEEDSPORT, NY 13166 | $6K |
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 | 365 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 101 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE UNION LABOR LIFE INSURANCE CO | 221 | $31K |
| Short-term disability | THE UNION LABOR LIFE INSURANCE CO | 375 | $12K |
| Other(3 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE CO | 375 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 375 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.