| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STERLING AND STERLING, INC.3 Filed as: STERLING AND STERLING | PO BOX 9017 WOODBURY, NY 11797 | AETNA LIFE INSURANCE COMPANY | $57K | $0 | $57K | 1.92% |
| EMERSON REID LLC3 | 350 5TH AVENUE, SUITE 3700 NEW YORK, NY 10118 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $14K | $14K | 11.14% |
| STERLING AND STERLING, INC.3 Filed as: STERLING AND STERLING INC. | PO BOX 9017 WOODBURY, NY 11797 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | $0 | $5K | 4.96% |
| EMERSON REID LLC3 Filed as: EMERSON REID AND COMPANY, INC. | 1787 SENTRY PARKWAY WEST VEVA 16, SUITE 320 BLUE BELL, PA 19422 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $4K | $4K | 3.97% |
| EMERSON REID LLC3 | 350 5TH AVENUE, SUITE 3700 NEW YORK, NY 10118 | COMPANION LIFE INSURANCE COMPANY | $0 | $9K | $9K | 11.40% |
| STERLING AND STERLING, INC.3 Filed as: STERLING AND STERLING | PO BOX 9017 WOODBURY, NY 11797 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 3.05% |
| JNAZ INC3 Filed as: JNAZ INC. | 145 MIDDLEVILLE ROAD NORTHPORT, NY 11768 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.69% |
| MICHELLE DARTEE3 | 58 FIELDSTONE TRAIL SPARTA, NJ 07871 | THE PAUL REVERE LIFE INSURANCE COMPANY | $439 | $10 | $449 | 1.17% |
| ADVANCED VOLUNTARY CONCEPTS INC3 Filed as: ADVANCED VOLUNTARY CONCEPTS INC. | 75 SOUTH BROADWAY WHITE PLAINS, NY 10601 | THE PAUL REVERE LIFE INSURANCE COMPANY | $205 | $0 | $205 | 0.53% |
| ANDREW THOMAS CABRERA3 | 115 MORRIS STREET JERSEY CITY, NJ 07302 | THE PAUL REVERE LIFE INSURANCE COMPANY | $132 | $0 | $132 | 0.34% |
| WILLIAM M. PELOSO3 | 41 ROCK SPRING ROAD STAMFORD, CT 10708 | THE PAUL REVERE LIFE INSURANCE COMPANY | $94 | $0 | $94 | 0.24% |
| MJ INSURANCE3 Filed as: CHARLENE ALPAY AND VARIOUS AGENTS | 606 WEST 116TH STREET NEW YORK, NY 10027 | THE PAUL REVERE LIFE INSURANCE COMPANY | $59 | $0 | $59 | 0.15% |
| STERLING AND STERLING, INC.3 Filed as: STERLING AND STERLING | PO BOX 9017 WOODBURY, NY 11797 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 10.88% |
| STERLING AND STERLING, INC.3 Filed as: STERLING AND STERLING LLC | PO BOX 9017 WOODBURY, NY 11797 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $414 | $0 | $414 | 8.58% |
| CHARLENE ALPAY3 | 606 WEST 116TH STREET NEW YORK, NY 10027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $252 | $90 | $342 | 7.09% |
| JNAZ INC3 Filed as: JNAZ INC. | 145 MIDDLEVILLE ROAD NORTHPORT, NY 11768 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $247 | $0 | $247 | 5.12% |
| MICHELLE DARTEE3 | 58 FIELDSTONE TRAIL SPARTA, NJ 07871 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $141 | $68 | $209 | 4.33% |
| WENDY ELIZABETH WESOLOWSKI3 | 1284 NORTH 12TH AVENUE PENSACOLA, FL 32503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $0 | $54 | 1.12% |
| CLARICE R MIMS3 Filed as: CLARICE R. MIMS | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.15% |
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 | 205 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 319 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 120 | $91K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 228 | $15K |
| Life insurance(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 209 | $205K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 209 | $127K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 209 | $127K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 319 | $2.9M |
| Other(3 contracts, 3 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 209 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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.