| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENV INSURANCE AGENCY LLC3 | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | EXCELLUS BLUECROSS BLUESHIELD PLAN | $63K | — | $63K | 3.89% |
| ENV INSURANCE AGENCY LLC3 | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | AMERITAS LIFE INSURANCE CORP OF NY | $1K | — | $1K | 3.56% |
| ENV INSURANCE AGENCY LLC | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | HM LIFE INSURANCE CO. | $1K | — | $1K | 10.00% |
| ENV INSURANCE AGENCY LLC | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $730 | — | $730 | 10.00% |
| AP BENEFIT ADVISORS, LLC | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $536 | — | $536 | 10.00% |
| ALLIANCE ADVISORY GRP INC Filed as: ALLIANCE ADVISORY GROUP, INC. | 600 DELAWARE AVE BUFFALO, NY 14202 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11 | — | $11 | 0.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| D'ARCANGELO & CO., LLP EIN 13-2550103 NONE | Accounting (including auditing) Service code 10 | 120 LOMOND COURT UTICA, NY 13502 | $11K |
| BLITMAN & KING, LLP EIN 16-1047304 NONE | Legal Service code 29 | 443 NORTH FRANKLIN STREET SYRACUSE, NY 13204 | $7K |
| TELEDOC HEALTH INC. EIN 04-3705970 NONE | Insurance services Service code 23 | 1945 LAKEPOINTE DRIVE LEWISVILLE, TX 75057 | $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 | 268 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 177 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 445 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD PLAN | 107 | $1.6M |
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP OF NY | 92 | $49K |
| Vision(3 contracts, 3 carriers) | AMERITAS LIFE INSURANCE CORP OF NY | 147 | $62K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD PLAN | 107 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.