| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN BENEFITS GROUP, INC.3 | 2914 PINE AVE NIAGARA FALLS, NY 14301 | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUE SHIELD OF WESTERN NEW YORK | $39K | — | $39K | 2.60% |
| CROWN BENEFITS GROUP, INC.3 | 2914 PINE AVE NIAGARA FALLS, NY 14301 | DELTA DENTAL OF NEW YORK, INC. | $3K | — | $3K | 3.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRONCONI SEGARRA & ASSOCIATES, LLP EIN 04-3728817 ACCOUNTANT | Accounting (including auditing) Service code 10 | 8321 MAIN STREET WILLIAMSVILLE, NY 14221 | $7K |
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUE SHIELD OF WESTERN NEW YORK | 230 | $1.5M |
| Dental | DELTA DENTAL OF NEW YORK, INC. | 241 | $82K |
| Prescription drug | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUE SHIELD OF WESTERN NEW YORK | 230 | $1.5M |
| Other | HEALTHNOW NEW YORK, INC. DBA BLUECROSS BLUE SHIELD OF WESTERN NEW YORK | 230 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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.