| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARBRIDGE CONSULTING GROUP LLC3 | ONE LINCOLN CENTER 12TH FLOOR SYRACUSE, NY 13202 | EXCELLUS BLUE CROSS BLUE SHIELD | $94K | — | $94K | 1.84% |
| ENV INSURANCY AGENCY3 | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | EXCELLUS BLUE CROSS BLUE SHIELD | $19K | — | $19K | 0.37% |
| LIFETIME BENEFIT SOLUTIONS, INC.3 Filed as: LIFETIME BENEFIT SOLUTIONS | 115 CONTINUUM DRIVE LIVERPOOL, NY 13088 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | — | $21K | 11.28% |
| ENV INSURANCE AGENCY LLC3 Filed as: ENV INSURANCE AGENCY | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 3.80% |
| ENV INSURANCY AGENCY3 | 7789 OSWEGO ROAD LIVERPOOL, NY 13090 | HM LIFE INSURANCE COMPANYDAVIS VISION | $5K | — | $5K | 10.00% |
| RAYMOND SINDONE3 | 140 FIRESIDE LANE CAMILLUS, NY 13031 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 5.38% |
| MICHAEL KASCH3 Filed as: MICHAEL DIGIROLOMO | 4106 MATAURO DRIVE LIVERPOOL, NY 13090 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 5.38% |
| NYLIFE SECURITIES LLC3 Filed as: NYLIFE SECURITIES | 51 MADISON AVE ROOM 606 NEW YORK, NY 10010 | FIRST UNUM LIFE INSURANCE COMPANY | $221 | — | $221 | 0.67% |
| RAYMOND SINDONE3 | 140 FIRESIDE LANE CAMILLUS, NY 13031 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 5.96% |
| MICHAEL KASCH3 Filed as: MICHAEL DIGIROLOMO | 4106 METAURO DRIVE LIVERPOOL, NY 13090 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 5.96% |
| NYLIFE SECURITIES LLC3 Filed as: NYLIFE SECURITIES | 51 MADISON AVE ROOM 606 NEW YORK, NY 10010 | FIRST UNUM LIFE INSURANCE COMPANY | $155 | — | $155 | 0.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFETIME BENEFIT SOLUTIONS EIN 16-1171765 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | 115 CONTINUUM DRIVE LIVERPOOL, NY 13088 | $12K |
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 | 1,758 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,769 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 353 | $5.1M |
| Vision | HM LIFE INSURANCE COMPANYDAVIS VISION | 1,062 | $52K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,758 | $190K |
| Long-term disability(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 72 | $57K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,758 | $190K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,758 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.