No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ONEAMERICA RETIREMENT SERVICES EIN 46-5378846 RECORDKEEPER | Participant loan processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees; Participant communication; Account maintenance fees Service code 15 | — | $131K |
| BLUE WATER ADVISORS INVESTMENT ADVISOR | Investment advisory (participants); Investment management fees paid directly by plan Service code 26 | 133 EAST MAIN STREET SUITE 2D BABYLON, NY 11702 | $31K |
| JOHN HANCOCK LIFE INSURANCE COMPANY EIN 01-0233346 RECORDKEEPER | Copying and duplicating; Trustee (bank, trust company, or similar financial institution); Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Participant loan processing; Account maintenance fees; Custodial (securities); Recordkeeping fees; Direct payment from the plan; Participant communication Service code 15 | — | $28K |
| QCI ASSET MANAGEMENT INVESTMENT ADVISOR | Investment management fees paid directly by plan; Investment advisory (participants) Service code 26 | 40A GROVE STREET PITTSFORD, NY 14534 | $14K |
| COBBLESTONE CAPITAL ADVISORS EIN 16-1543732 INVESTMENT ADVISOR | Investment management fees paid directly by plan; Investment advisory (participants) Service code 26 | — | $9K |
| MG TRUST COMPANY DBA MATRIX TRUST C EIN 75-3182674 CUSTODIAN/RECORDKEEPER | Direct payment from the plan; Custodial (securities); Copying and duplicating; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees; Sub-transfer agency fees; Participant communication; Account maintenance fees; Consulting (general); Participant loan processing Service code 15 | — | $0 |
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 | 390 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 223 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 613 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMERITAS LIFE INSURANCE COMPANY | 1 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1 | — |
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.