| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES IN | 980 WASHINGTON STREET DEDHAM, MA 02026 | AETNA LIFE INSURANCE CO. | $2K | — | $2K | 0.88% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA LIFE INSURANCE COMPANY | $15K | — | $15K | 11.76% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | 980 WASHINGTON STREET DEDHAM, MA 02026 | TRANSAMERICA LIFE INSURANCE COMPANY | $7K | — | $7K | 5.88% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | ELIXIR INSURANCE COMPANY | $3K | — | $3K | 4.02% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | 980 WASHINGTON STREET DEDHAM, MA 02026 | ELIXIR INSURANCE COMPANY | $2K | — | $2K | 3.22% |
| ONEGROUP NY INC3 | 706 NORTH CLINTON STREET SYRACUSE, NY 13204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.89% |
| ARCHON LLC3 | 225 WIRELESS BOULEVARD SUITE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 5.00% |
| ONEGROUP NY INC3 | 706 NORTH CLINTON STREET SYRACUSE, NY 13204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.80% |
| ARCHON LLC3 | 225 WIRELESS BLVD SUITE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 5.00% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | COMPANION LIFE INSURANCE COMPANY - COLUMBIA | $3K | — | $3K | 11.66% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | 980 WASHINGTON STREET DEDHAM, MA 02026 | COMPANION LIFE INSURANCE COMPANY - COLUMBIA | $833 | — | $833 | 3.45% |
| ONEGROUP NY INC3 | 706 NORTH CLINTON STREET SYRACUSE, NY 13204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 20.00% |
| ARCHON LLC3 | 225 WIRELESS BOULEVARD SUITE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 5.00% |
| ONEGROUP NY INC3 | 706 NORTH CLINTON STREET SYRACUSE, NY 13204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $308 | — | $308 | 11.99% |
| ARCHON LLC3 | 225 WIRELESS BOULEVARD SUITE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $128 | $128 | 4.98% |
| ONEGROUP NY INC3 | 706 NORTH CLINTON STREET SYRACUSE, NY 13204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $130 | — | $130 | 20.03% |
| ARCHON LLC3 | 225 WIRELESS BOULEVARD SUITE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $32 | $32 | 4.93% |
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 | 385 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 391 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 57 | $2.4M |
| Dental | AETNA LIFE INSURANCE CO. | 386 | $187K |
| Vision | AETNA LIFE INSURANCE CO. | 386 | $187K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 380 | $49K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 380 | $34K |
| Prescription drug | TRANSAMERICA LIFE INSURANCE COMPANY | 30 | $124K |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 380 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 386 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.