| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $117K | $70K | $187K | 4.35% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $76K | $45K | $120K | 4.34% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $50K | $25K | $75K | 5.51% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $22K | $9K | $30K | 6.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | 1500 MARKET STREET PHILADELPHIA, PA 19102 | EXCELLUS BLUE CROSS BLUE SHIELD | $18K | — | $18K | 4.56% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $20K | $6K | $26K | 6.71% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 2.52% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE RD 5TH FL BURLINGTON, VT 05401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $691 | — | $691 | 0.61% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $7K | $1K | $9K | 8.76% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $5K | $2K | $6K | 7.20% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE AGENCY INC | 1 EMPIRE DRIVE RENSSELAER, NY 121445729 | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | $5K | — | $5K | 5.43% |
| MICHAEL P TUMBARELLO3 | 22 US OVAL STE 118 PLATTSBURGH, NY 12903 | AFLAC | $2K | — | $2K | 4.15% |
| CHARLES T JOHNSON3 | 2491 NE PINECREST LAKES BLVD JENSEN BEACH, FL 34957 | AFLAC | $656 | — | $656 | 1.79% |
| MELISSA ANN STEWART3 | 36 WINCOMA LN QUEENSBURY, NY 12804 | AFLAC | $396 | — | $396 | 1.08% |
| ANTHONY MORAN JR3 | 11121 STATE RT 9 CHAMPLAIN, NY 12919 | AFLAC | $299 | — | $299 | 0.82% |
| JESSIE JENNETT3 | 37 BOYNTON AVE STE 3 PLATTSBURGH, NY 12901 | AFLAC | $268 | — | $268 | 0.73% |
| ROBERT HAMILTON3 Filed as: ROBERT T HAMILTON | 105 CHESTERFIELD ST KEESEVILLE, NY 12944 | AFLAC | $175 | — | $175 | 0.48% |
| DARRYL J YOUNG3 | 3820 GOLD CITY RD FRANKLIN, KY 42134 | AFLAC | $137 | — | $137 | 0.37% |
| LISA J BRENNAN-JONES3 | 29 OAK LN LAKE GEORGE, NY 12845 | AFLAC | $86 | — | $86 | 0.23% |
| JOHN E PORTER3 | 200 MCGLOCKLIN WAY BOWLING GREEN, KY 42101 | AFLAC | $85 | — | $85 | 0.23% |
| GETA RABIDEAU3 | PO BOX 948 DANNEMORA, NY 12929 | AFLAC | $68 | — | $68 | 0.19% |
| KELLY A IRVINE3 | 15801 WHITE ORCHID LN FORT MYERS, FL 33908 | AFLAC | $61 | — | $61 | 0.17% |
| FRANK ARTHUR COUCH3 | 1041 DONALD ST CONWAY, SC 29527 | AFLAC | $56 | — | $56 | 0.15% |
| ALLAN STAFFORD3 | 80 PLEASANT ST LOT 4 PERU, NY 12972 | AFLAC | $45 | — | $45 | 0.12% |
| JOSEPH STOCKMAN3 Filed as: JOSEPH R STOCKMAN | 1270 GOODMORNING DR NASHVILLE, TN 37207 | AFLAC | $38 | — | $38 | 0.10% |
| SUSAN C BRIMHALL3 | PO BOX 8 LAKE PLACID, NY 12946 | AFLAC | $27 | — | $27 | 0.07% |
| ANN P WILLETTE3 | 162 SWINYER RD VERMONTVILLE, NY 12989 | AFLAC | $18 | — | $18 | 0.05% |
| JEFF DALABA3 | 8500 GILLY FLOWER CT BALDWINSVILLE, NY 13027 | AFLAC | $16 | — | $16 | 0.04% |
| NORTHERN INSURING AGENCY INC.3 Filed as: NORTHERN INSURING AGENCY INC | 171 MARGARET ST PLATTSBURGH, NY 12901 | AFLAC | $16 | — | $16 | 0.04% |
| ROSANN M CURRAN3 | 1536 RIDGE RD QUEENSBURY, NY 12804 | AFLAC | $15 | — | $15 | 0.04% |
| BRAD JONES AND ASSOCIATES INC3 | 19 BRITISH AMERICAN BLVD LATHAM, NY 12110 | AFLAC | $13 | — | $13 | 0.04% |
| SUSAN CHILLE3 Filed as: SUSAN E CHILLE | 12 ST THOMAS MORE DR WINCHESTER, MA 01890 | AFLAC | $7 | — | $7 | 0.02% |
| MCINERNEY GROUP LLC3 | 14 STILLMAN LN PLEASANTVILLE, NY 10570 | AFLAC | $7 | — | $7 | 0.02% |
| CHERYL A ROTONDI3 | 1061 KATHAN RD CORINTH, NY 12822 | AFLAC | $5 | — | $5 | 0.01% |
| RUSSELL T BARRETT3 | 27 JULIANS WAY SARATOGA SPRINGS, NY 12866 | AFLAC | $5 | — | $5 | 0.01% |
| KAREN L NORTON3 | 18 PUNTA CT FORT MYERS, FL 33912 | AFLAC | $5 | — | $5 | 0.01% |
| KEVIN MCCARTHY3 | 197 LANG DR NORTH KINGSTOWN, RI 02852 | AFLAC | $4 | — | $4 | 0.01% |
| KENNETH J HANNAN3 | 5 FRIAR TUCK CT CLIFTON PARK, NY 12065 | AFLAC | $4 | — | $4 | 0.01% |
| IRMA MATILDE WOODARD3 | 7684 STATE ROUTE 66 AVERILL PARK, NY 12018 | AFLAC | $3 | — | $3 | 0.01% |
| TOMAS E FLORES3 | 2030 HUDSON ST APT 942 FORT LEE, NJ 07024 | AFLAC | $3 | — | $3 | 0.01% |
| KEVIN MURPHY3 | 11 WILLOWBROOK TER CLIFTON PARK, NY 12065 | AFLAC | $3 | — | $3 | 0.01% |
| LAURIE L SMITH3 | 577 TRUESDALE HILL RD LAKE GEORGE, NY 12845 | AFLAC | $2 | — | $2 | 0.01% |
| DAVID B PERLEE3 | 1989 NEPTUNE DR ENGLEWOOD, FL 34223 | AFLAC | $2 | — | $2 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 | 1500 MARKET STREET PHILADELPHIA, PA 19102 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 9.35% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE AGENCY INC | ONE EMPIRE DRIVE RENSSELAER, NY 12144 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $167 | — | $167 | 4.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENERFIT SERVICES INC | 1 JERICHO PLZ STE 200 JERICHO, NY 11753 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $32 | — | $32 | 0.90% |
| GORMAN, JOHN, W3 | 176 N SHORE DR CLAYTON, NY 13624 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $10 | — | $10 | 0.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENERFIT SERVICES INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $3 | — | $3 | 0.08% |
| WILLIS TOWERS WATSON US LLC3 | 335 MADISON AVE NEW YORK, NY 10017 | HARTFORD LIFE AND ACCIDENT | $113 | $11 | $124 | 16.53% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | EYEMED VISION CARE | $208 | — | $208 | — |
| WILLIS TOWERS WATSON US LLC3 | 75 ARLINGTON STREET, FLOOR 10 BOSTON, MA 02116 | HARTFORD LIFE AND ACCIDENT | $3K | $1K | $4K | — |
No Schedule C service providers reported on this filing.
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 | 12,621 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,022 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 13,643 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 26 | $392K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 28 | $17K |
| Vision(3 contracts, 3 carriers) | VISION SERVICE PLAN | 7,809 | $1.3M |
| Life insurance(7 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 7,787 | $6.7M |
| Short-term disability(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,174 | $1.9M |
| Long-term disability(7 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 7,787 | $9.0M |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 26 | $392K |
| Other(12 contracts, 7 carriers) | HARTFORD LIFE AND ACCIDENT | 2,269 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,809 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.