| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LILA MARKETING LLC | — | DAVIS VISION | $4K | — | $4K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | 333 BUTTERNUT DRIVE SYRACUSE, NY 13214 | $128K |
| ONE GROUP NY INC. EIN 16-1593071 NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | 5232 WITZ DRIVE NORTH SYRACUSE, NY 13212 | $65K |
| BLITMAN & KING EIN 16-1047304 NONE | Legal; Direct payment from the plan Service code 29 | 443 NORTH FRANKLIN STREET SYRACUSE, NY 13204 | $38K |
| GALLAGHER BENEFIT SERVICES EIN 20-2532319 NONE | Consulting (general); Direct payment from the plan Service code 16 | 85 CHESTNUT RIDGE ROAD SUITE 214 MONTVALE, NJ 07645 | $36K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | 100 LOWDER BROOKE DRIVE WESTWOOD, MA 02090 | $34K |
| LOOMIS SAYLES TRUST COMPANY EIN 20-8080381 NONE | Investment management fees paid directly by plan Service code 51 | ONE FINANCIAL CENTER BOSTON, MA 02111 | $19K |
| WELLINGTON TRUST EIN 04-2755549 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 280 CONGRESS STREET BOSTON, MA 02210 | $18K |
| LOOMIS SAYLES & COMPANY EIN 04-3200030 NONE | Investment management fees paid directly by plan Service code 51 | ONE FINANCIAL CENTER BOSTON, MA 02111 | $13K |
| D'ARCANGELO & CO., LLP EIN 13-2550103 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 120 LOMOND CT UTICA, NY 13502 | $7K |
| JUST THE RIGHT STUFF EIN 16-1407121 NONE | Other services; Direct payment from the plan Service code 49 | 103 TWIN OAKS DRIVE SYRACUSE, NY 13206 | $7K |
| STATE STREET GLOBAL ADVISORS EIN 04-1867445 PARTY-IN-INTEREST | Investment management; Direct payment from the plan; Custodial (securities) Service code 19 | 200 NEW PORT AVENUE QUINCY, MA 02171 | $5K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 392 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 392 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | DAVIS VISION | 691 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 691 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.