| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK | — | CIGNA HEALTH & LIFE INSURANCE COMPANY | $21K | — | $21K | 1.87% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC | — | CIGNA HEALTH & LIFE INSURANCE COMPANY | $7K | — | $7K | 0.62% |
| EMS FINANCIAL SERVICES LLC3 Filed as: EMS FINANCIAL SERVICES | — | EXCELLUS BLUE CROSS BLUE SHIELD | $7K | — | $7K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Redemption fees; Contract Administrator Service code 12 | — | $1.7M |
| EXCELLUS BLUE CROSS BLUE SHIELD EIN 15-0329043 NONE | Direct payment from the plan; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $968K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $286K |
| VIRGINIA & AMBINDER, LLP EIN 13-4166736 NONE | Legal; Direct payment from the plan Service code 29 | — | $234K |
| SIERRA INVESTMENT PARTNERS, INC. EIN 68-0370668 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $231K |
| CHARTWELL INVESTMENT PARTNERS, LLC EIN 36-4776242 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $210K |
| ROSEANN HAINES EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $161K |
| REVOLT GROUP LLC NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 929 S HIGH STREET SUITE 182 WEST CHESTER, PA 19382 | $142K |
| LORD ABBETT & CO. LLC EIN 13-5620131 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $141K |
| ORHAN COSKUNER EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $131K |
| DAVIS VISION NONE | Direct payment from the plan; Insurance services Service code 23 | 175 E. HOUSTON ST 5TH FLOOR SAN ANTONIO, TX 78205 | $125K |
| BASYS INC EIN 52-1796473 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $122K |
| KIM SENNES EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $119K |
| WEDGE CAPITAL MANAGEMENT EIN 56-1557450 NONE | Investment management fees paid directly by plan; Investment management; Soft dollars commissions; Investment management fees paid indirectly by plan Service code 28 | — | $114K |
| MICHELLE DARRAGH EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $113K |
| ARCARA ZUCARELLI LENDA & ASSOCIATES EIN 47-1793720 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $108K |
| PROFLEX ADMINISTRATIORS LLC NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 8321 MAIN STREET WILLIAMSVILLE, NY 14221 | $106K |
| KIM TOMPURI EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $105K |
| MARSHALL & MOSS PAYROLL COMPLIANCE EIN 04-3652965 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $88K |
| EXPRESS SCRIPTS EIN 22-3461740 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $87K |
| SUSANIN WIDMAN & BRENNAN PC EIN 23-2265950 NONE | Legal; Direct payment from the plan Service code 29 | — | $84K |
| PENNY CRONK EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| ERIN CECCUCCI EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| LISA BRIENZA EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| MARY SIEMION EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| SLEVIN & HART, P.C. EIN 52-1708613 NONE | Legal; Direct payment from the plan Service code 29 | — | $63K |
| LISA BIFULCO EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $61K |
| KAREN PALMER EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| KYLE LAGONEGRO EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $59K |
| LINDA BAZEWICK EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $55K |
| ABIGAIL BONILLA EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| KIMBERLY GERBER EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $52K |
| MARGARET LIGHTFOOT EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $52K |
| ALLYSON NAURONIS EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $51K |
| FIRST ACTUARIAL CONSULTING, INC. EIN 26-3842522 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $49K |
| RYAN-ASHLEY PAOLINO EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $48K |
| ALLISON CHARNOW EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $43K |
| MARY YEAGER EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $42K |
| ANGELA COYLE EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $41K |
| JASON RANDOLPH EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $40K |
| DIANE SHADDUCK EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $38K |
| AMY CHROPUFKA EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $38K |
| ANNE SIDOTI EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $38K |
| SANDRA REILLY EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $38K |
| KATHLEEN MORIN EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $37K |
| CYNTHIA COATS EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $36K |
| DENISE COSSARO EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $34K |
| WILLIAM KISTINGER EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $34K |
| JOANN PETERSON EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $32K |
| DONNA ALIFFI EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $31K |
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 | 7,337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,220 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 9,557 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 235 | $923K |
| Dental | CIGNA HEALTH & LIFE INSURANCE COMPANY | 1,550 | $1.1M |
| Prescription drug(2 contracts, 2 carriers) | EXCELLUS BLUECROSS BLUESHIELD | 235 | $985K |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUE CROSS BLUE SHIELD | 2,829 | $148K |
| Other | EXCELLUS BLUECROSS BLUESHIELD | 235 | $923K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,829 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.