| 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 | $40K | $0 | $40K | 2.33% |
| MARTHINSEN & SALVITTI INSURANCE GRO3 Filed as: MARTHINSEN & SALVITTI INS. GRP | 140 PARK AVE WASHINGTON, PA 15301 | UPMC HEALTH OPTIONS | $19K | $0 | $19K | 3.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE ITASCA, IL 60143 | COMMUNITY INSURANCE COMPANY | $10K | $0 | $10K | 1.65% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 1340 DEPOT STREET ROCKY RIVER, OH 44116 | COMMUNITY INSURANCE COMPANY | $9K | $0 | $9K | 1.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY, INC | PO BOX 416315 BOSTON, MA 02241 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | $744 | $14K | 9.53% |
| 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 | 4.78% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY, INC. | PO BOX 416315 BOSTON, MA 02241 | VISION SERVICE PLAN | $839 | $0 | $839 | 6.71% |
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 | 285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 289 | 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 | 256 | $3.1M |
| Dental(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 328 | $715K |
| Vision | VISION SERVICE PLAN | 125 | $13K |
| Prescription drug | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 256 | $1.7M |
| Other | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 256 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 328 | — |
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.