| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 NORTH FRANKLIN ST. STE 20 SYRACUSE, NY 13204 | MVP HEALTHCARE | $75K | — | $75K | 3.04% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 NORTH FRANKLIN ST. STE 20 SYRACUSE, NY 13204 | HM LIFE INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 10.03% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 NORTH FRANKLIN ST. STE 20 SYRACUSE, NY 13204 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE ST STE 210 UTICA, NY 13501 | THE PAUL REVERE LIFE INSURANCE COMPANY | $892 | — | $892 | 6.43% |
| BMB BENEFITS GROUP INC3 Filed as: BMB BENEFITS GROUP | 334 GRAY ST HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $627 | $70 | $697 | 5.02% |
| DONALD H MATSON3 | 8 ROSEWOOD DR AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $204 | $17 | $221 | 1.59% |
| KEVIN EDWARDS3 | 8332 MOYER CARRIAGE CICERO, NY 13039 | THE PAUL REVERE LIFE INSURANCE COMPANY | $157 | — | $157 | 1.13% |
| MELISSA PINE3 Filed as: MELISSA BEAUCHEMIN | 334 GRAY STREET HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $96 | $8 | $104 | 0.75% |
| MEAGAN M MARTIN3 | 517 PARK AVENUE SYRACUSE, NY 13204 | THE PAUL REVERE LIFE INSURANCE COMPANY | $66 | — | $66 | 0.48% |
| TRISHA TYMINSKI3 | PO BOX 439 CONSTANTIA, NY 13044 | THE PAUL REVERE LIFE INSURANCE COMPANY | $28 | — | $28 | 0.20% |
| VALERIE CELI3 | 6530 LAKESHORE RD CICERO, NY 13039 | THE PAUL REVERE LIFE INSURANCE COMPANY | $20 | — | $20 | 0.14% |
| ANTHONY MATRONE3 | 4297 ROUTE 31 CLAY, NY 13041 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 NORTH FRANKLIN ST. STE 20 SYRACUSE, NY 13204 | COMPANION LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| ALISHA K ROBINSON3 Filed as: ALISHA ROBINSON | PO BOX 272 OLD FORGE, NY 13420 | AFLAC | $418 | — | $418 | 8.08% |
| AFS AGENCY3 | 185 GENESEE ST STE 210 UTICA, NY 13501 | AFLAC | $145 | — | $145 | 2.80% |
| JOSEPH P CALARCO3 Filed as: JOSEPH CALARCO | PO BOX 130 AUBURN, NY 13021 | AFLAC | $126 | — | $126 | 2.43% |
| JEFFERY S. KOWALSKY3 Filed as: JEFFERY S KOWALSKY | 2530 CHURCH ROAD SAUQUOIT, NY 13456 | AFLAC | $104 | — | $104 | 2.01% |
| DAWN PELLERIN3 | 34 TAMARACK DR NEW HARTFORD, NY 13413 | AFLAC | $33 | — | $33 | 0.64% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 NORTH FRANKLIN ST. STE 20 SYRACUSE, NY 13204 | AFLAC | $25 | — | $25 | 0.48% |
| SCOTT THORNTON3 | 4850 STATE ROUTE 69 ROME, NY 13440 | AFLAC | $25 | — | $25 | 0.48% |
| LAURA ANNE CALARCO3 | 340 HORSE CREEK DR APT 208 NAPLES, FL 34110 | AFLAC | $17 | — | $17 | 0.33% |
| NICHOLAS CALARCO3 | 162 YORK ST AUBURN, NY 13021 | AFLAC | $5 | — | $5 | 0.10% |
| KELLY A IRVINE3 Filed as: KELLY IRVINE | 15801 WHITE ORCHID LN FORT MYERS, FL 33908 | AFLAC | $2 | — | $2 | 0.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST. SYRACUSE, NY 13204 | FIRST UNUM LIFE INSURANCE COMPANY | $16 | — | $16 | 3.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 | Claims processing Service code 12 | 165 COURT STREET ROCHESTER, NY 14647 | $10K |
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 | 710 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 715 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTHCARE | 255 | $2.5M |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 218 | $20K |
| Life insurance(3 contracts, 3 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 130 | $26K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 130 | $17K |
| Prescription drug | MVP HEALTHCARE | 255 | $2.5M |
| Other(3 contracts, 3 carriers) | MVP HEALTHCARE | 255 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.
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.