| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ONEGROUP NY INC3 | 706 N CLINTON STREET SYRACUSE, NY 13204 | EXCELLUS BLUECROSS BLUESHIELD | $110K | — | $110K | 2.44% |
| PETER DERRENBACKER3 | 34 ASPEN PARK BLVD EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $5K | $1K | $6K | 2.29% |
| ROBERT DERRENBACKER3 | 34 ASPEN PARK BLVD. EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $2K | $377 | $2K | 0.75% |
| RP DODD GROUP INC3 | 34 ASPEN PARK BLVD EAST SYRACUSE, NY 13057 | NORTHWESTERN MUTUAL | $1K | $128 | $2K | 0.59% |
| ONEGROUP NY INC3 | 706 N CLINTON STREET SYRACUSE, NM 13204 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 6.66% |
| VANGUARD II INC3 Filed as: VANGUARD RISK MANAGERS INC | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $8K | $8K | 3.91% |
| NATIONAL BENEFITS CENTER LLC3 | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.65% |
| ONEGROUP NY INC3 Filed as: ONEGROUP NY INC. | 706 N CLINTON STREET SYRACUSE, NY 13204 | VISION SERVICE PLAN (VSP) | $2K | — | $2K | 3.35% |
| GARY WELTMANN3 Filed as: GARY F. WELTMANN | P.O. BOX 59816 POTOMAC, MD 20859 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $2K | $11K | 26.46% |
| ONEGROUP NY INC3 | 706 N CLINTON STREET SYRACUSE, NY 13204 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 11.12% |
| VANGUARD II INC3 Filed as: VANGUARD RISK MANAGERS INC | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 6.35% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $134 | — | $134 | 0.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFETIME BENEFIT SOLUTIONS EIN 16-1171765 THIRD PARTY ADMIN | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 115 CONTINUUM DRIVE LIVERPOOL, NY 13088 | $8K |
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 | 348 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 45 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 393 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | EXCELLUS BLUECROSS BLUESHIELD | 359 | $4.7M |
| Vision | VISION SERVICE PLAN (VSP) | 316 | $60K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 481 | $209K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 329 | $19K |
| Long-term disability | NORTHWESTERN MUTUAL | 480 | $268K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 359 | $4.5M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 481 | $250K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 481 | — |
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.