| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AFS AGENCY3 | 185 GENESEE ST STE 210 UTICA, NY 13501 | EXCELLUS | $131K | $0 | $131K | 5.15% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 N FRANKLIN ST SYRACUSE, NY 13204 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $48K | $8K | $55K | 11.57% |
| AFS AGENCY3 | 185 GENESEE STREET STE 210 UTICA, NY 13501 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 12.61% |
| AFS AGENCY3 | 185 GENESEE ST STE 210 UTICA, NY 13501 | HM LIFE INSURANCE COMPANY OF NEW YORK | $3K | — | $3K | 10.00% |
| KEVIN EDWARDS3 | 8332 MOYER CARRIAGE CICERO, NY 13039 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $1K | $2K | 11.73% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE ST STE 210 UTICA, NY 13501 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.68% |
| MEAGAN M MARTIN3 | 721 NORTH CLINTON STREET SYRACUSE, NY 13204 | THE PAUL REVERE LIFE INSURANCE COMPANY | $559 | $627 | $1K | 5.84% |
| TRISHA TYMINSKI3 | PO BOX 439 CONSTANTIA, NY 13044 | THE PAUL REVERE LIFE INSURANCE COMPANY | $266 | $0 | $266 | 1.31% |
| MELISSA PINE1 | 708 PARK AVE HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $123 | $0 | $123 | 0.61% |
| VALERIE CELI3 | 6530 LAKESHORE RD CICERO, NY 13039 | THE PAUL REVERE LIFE INSURANCE COMPANY | $40 | $0 | $40 | 0.20% |
| ANTHONY MATRONE3 | 4797 ROUTE 31 CLAY, NY 13041 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.02% |
| ALISHA K ROBINSON3 Filed as: ALISHA ROBINSON | PO BOX 272 OLD FORGE, NY 13420 | AFLAC | $1K | $5 | $1K | 9.71% |
| AFS AGENCY3 | 185 GENESEE STREET STE 210 UTICA, NY 13501 | AFLAC | $747 | — | $747 | 6.30% |
| JEFFERY S. KOWALSKY3 Filed as: JEFFERY S KOWALSKY | 2530 CHURCH ROAD SAUQUOIT, NY 13456 | AFLAC | $322 | $70 | $392 | 3.30% |
| JOSEPH P CALARCO3 Filed as: JOSEPH CALARCO | PO BOX 130 63 GENESEE ST STE 2 AUBURN, NY 13021 | AFLAC | $369 | $20 | $389 | 3.28% |
| DAWN PELLERIN3 | 34 TAMARACK DR NEW HARTFORD, NY 13413 | AFLAC | $148 | $9 | $157 | 1.32% |
| LAURA BOHANNON3 | 23 S MARVINE AVE AUBURN, NY 13021 | AFLAC | $33 | $6 | $39 | 0.33% |
| JAMES REYNOLDS3 | 10 GROVE AVE NORWICH, NY 13815 | AFLAC | $20 | $0 | $20 | 0.17% |
| EDWARD D YATES JR3 Filed as: EDWARD YATES JR | 2063 COUNTY ROUTE 8 OSWEGO, NY 13126 | AFLAC | $19 | $0 | $19 | 0.16% |
| MICHAEL DAMSKY3 | 2113 GENESEE ST UTICA, NY 13051 | AFLAC | $17 | $0 | $17 | 0.14% |
| MARY FRANCES CARLTON3 Filed as: MARY CARLTON | 3824 HOGAN RD VERNON CENTER, NY 13477 | AFLAC | $9 | $0 | $9 | 0.08% |
| STEPHEN CONNORS3 | 108 HUNTSHILL RD SYRACUSE, NY 13209 | AFLAC | $8 | $0 | $8 | 0.07% |
| BRAD JONES AND ASSOCIATES INC3 Filed as: BRAD JONES AND ASSOCIATES | 19 BRITISH AMERICAN BLVD LATHAM, NY 12110 | AFLAC | $7 | $0 | $7 | 0.06% |
| RICHARD G SHEERAN3 | 460 N FRANKLIN ST APT 402 SYRACUSE, NY 13204 | AFLAC | $5 | $0 | $5 | 0.04% |
| KELLY A IRVINE3 Filed as: KELLY IRVINE | 20620 EAST GOLDEN ELM DR ESTERO, FL 33928 | AFLAC | $2 | $0 | $2 | 0.02% |
| JEFF DALABA3 | 8500 GILLY FLOWER CT BALDWINSVILLE, NY 13027 | AFLAC | $2 | $0 | $2 | 0.02% |
| KEVIN MURPHY3 | 11 WILLOWBROOK TER CLIFTON PARK, NY 12065 | AFLAC | $2 | $0 | $2 | 0.02% |
| KELLY A IRVINE3 Filed as: KELLY IRVINE | 15801 WHITE ORCHID LN FORT MYERS, FL 33908 | AFLAC | $2 | $0 | $2 | 0.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 117 W LIBERTY ST STE 2 ROME, NY 13441 | FIRST UNUM LIFE INSURANCE COMPANY | $17 | — | $17 | 4.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFETIME BENEFIT SOLUTIONS, INC EIN 16-1171765 | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 115 CONTINUUM DRIVE LIVERPOOL, NY 13088 | $15K |
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 | 1,128 | 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) | 1,134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS | 343 | $2.5M |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 293 | $25K |
| Life insurance(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 217 | $62K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 3,579 | $479K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 217 | $42K |
| Prescription drug | EXCELLUS | 343 | $2.5M |
| Other(3 contracts, 3 carriers) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 3,579 | $532K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,579 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.