| 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 | $72K | — | $72K | 2.82% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 NORTH FRANKLIN ST. STE 20 SYRACUSE, NY 13204 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CROWN RISK MANAGEMENT, LLC Filed as: CROWN RISK MANAGEMENT LLC | 432 N FRANKLIN ST, STE 20 SYRACUSE, NY 13204 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 N FRANKLIN ST, STE 20 SYRACUSE, NY 13204 | COMPANION LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE ST STE 210 UTICA, NY 13501 | THE PAUL REVERE LIFE INSURANCE COMPANY | $676 | — | $676 | 5.92% |
| BMB BENEFITS GROUP INC3 Filed as: BMB BENEFITS GROUP | 334 GRAY ST HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $635 | $23 | $658 | 5.76% |
| DONALD H MATSON3 | 8 ROSEWOOD DR AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $190 | $4 | $194 | 1.70% |
| KEVIN EDWARDS3 | 8332 MOYER CARRIAGE CICERO, NY 13039 | THE PAUL REVERE LIFE INSURANCE COMPANY | $106 | — | $106 | 0.93% |
| MEAGAN M MARTIN3 | 517 PARK AVENUE SYRACUSE, NY 13204 | THE PAUL REVERE LIFE INSURANCE COMPANY | $38 | — | $38 | 0.33% |
| TRISHA TYMINSKI3 | PO BOX 439 CONSTANTIA, NY 13044 | THE PAUL REVERE LIFE INSURANCE COMPANY | $20 | — | $20 | 0.18% |
| VALERIE CELI3 | 6530 LAKESHORE RD CICERO, NY 13039 | THE PAUL REVERE LIFE INSURANCE COMPANY | $18 | — | $18 | 0.16% |
| ANTHONY MATRONE3 | 4297 ROUTE 31 CLAY, NY 13041 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| ALISHA K ROBINSON3 | PO BOX 272 OLD FORGE, NY 13420 | AFLAC | $405 | $17 | $422 | 9.55% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 N FRANKLIN ST, STE 20 SYRACUSE, NY 13204 | AFLAC | $189 | — | $189 | 4.28% |
| JOSEPH P CALARCO3 | PO BOX 130 AUBURN, NY 13021 | AFLAC | $142 | $8 | $150 | 3.39% |
| AFS AGENCY3 | 185 GENESEE ST STE 210 UTICA, NY 13501 | AFLAC | $127 | — | $127 | 2.87% |
| REBECCA PITCHER3 | 46 SHULL ST ILION, NY 13357 | AFLAC | $117 | — | $117 | 2.65% |
| SCOTT THORNTON3 | 4850 STATE ROUTE 69 TRLR 2 ROME, NY 13440 | AFLAC | $77 | $9 | $86 | 1.95% |
| NICHOLAS CALARCO | 162 YORK ST AUBURN, NY 13021 | AFLAC | $40 | $2 | $42 | 0.95% |
| JEFFERY S. KOWALSKY3 Filed as: JEFFERY S KOWALSKY | 2530 CHURCH ROAD SAUQUOIT, NY 13456 | AFLAC | $31 | — | $31 | 0.70% |
| DAWN PELLERIN3 Filed as: DAWN M PELLERIN | 34 TAMARACK DR NEW HARTFORD, NY 13413 | AFLAC | $16 | — | $16 | 0.36% |
| KELLY A IRVINE3 | 15801 WHITE ORCHID LN FORT MYERS, FL 33908 | AFLAC | $1 | — | $1 | 0.02% |
| LAURA ANNE CALARCO3 | 340 HORSE CREEK DR APT 208 NAPLES, FL 34110 | AFLAC | $1 | — | $1 | 0.02% |
| 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 | $14 | — | $14 | 3.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 | Claims processing Service code 12 | 165 COURT STREET ROCHESTER, NY 14647 | $11K |
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 | 642 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 647 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTHCARE | 250 | $2.6M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 291 | $20K |
| Life insurance(3 contracts, 3 carriers) | COMPANION LIFE INSURANCE COMPANY | 119 | $23K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 119 | $18K |
| Prescription drug | MVP HEALTHCARE | 250 | $2.6M |
| Other(3 contracts, 3 carriers) | MVP HEALTHCARE | 250 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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.