| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD COMPANIES, INC | 801 MAIN STREET BUFFALO, NY 14203 | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $64K | $0 | $64K | 3.88% |
| MARTHINSEN & SALVITTI INSURANCE GRO3 Filed as: MARTHINSEN & SALVITTI INS. GRP | 140 PARK AVE WASHINGTON, PA 15301 | UPMC HEALTH OPTIONS | $21K | $0 | $21K | 3.34% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 1340 DEPOT STREET ROCKY RIVER, OH 44116 | COMMUNITY INSURANCE COMPANY | $15K | $1K | $16K | 3.57% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY, INC | PO BOX 416315 BOSTON, MA 02241 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $19K | $0 | $19K | 8.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC | PO BOX 416315 BOSTON, MA 02241 | AETNA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 4.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY, INC. | PO BOX 416315 BOSTON, MA 02241 | VISION SERVICE PLAN | $768 | $0 | $768 | 7.32% |
| WILLIS TOWERS WATSON US LLC Filed as: WILLIS OF NEW JERSEY INC | 150 JOHN F KENNEDY PKWY STE 520 SHORT HILLS, NJ 07016 | STANDARD INSURANCE COMPANY | $993 | $0 | $993 | 17.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $96 | $0 | $96 | 1.69% |
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 | 309 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 271 | $3.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 367 | $106K |
| Vision | VISION SERVICE PLAN | 68 | $10K |
| Long-term disability | STANDARD INSURANCE COMPANY | 15 | $6K |
| Prescription drug | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 271 | $1.7M |
| Other | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 271 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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."
No prospect flags tripped on this filing.