| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STERLING AND STERLING, INC.3 Filed as: STERLING & STERLING LLC | 135 CROSSWAYS PARK DRIVE, SUITE 300 WOODBURY, NY 11797 | UNITEDHEALTHCARE INSURANCE COMPANY | $66K | $0 | $66K | 1.95% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PARKWAY W VEVA 16, SUITE 320 BLUE BELL, PA 19422 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $17K | $17K | 12.50% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PARKWAY W VEVA 16, SUITE 320 BLUE BELL, PA 19422 | COMPANION LIFE INSURANCE COMPANY | $0 | $11K | $11K | 12.91% |
| STERLING AND STERLING, INC.3 Filed as: STERLING & STERLING LLC | 135 CROSSWAYS PARK DRIVE, SUITE 300 WOODBURY, NY 11797 | THE PAUL REVERE LIFE INSURANCE COMPANY | $847 | $0 | $847 | 2.61% |
| JNAZ INC3 | 145 MIDDLEVILLE ROAD NORTHPORT, NY 11768 | THE PAUL REVERE LIFE INSURANCE COMPANY | $787 | $0 | $787 | 2.43% |
| MICHELLE DARTEE3 | PO BOX 274 SPARTA, NJ 07871 | THE PAUL REVERE LIFE INSURANCE COMPANY | $321 | $0 | $321 | 0.99% |
| ADVANCE VOLUNTARY CONCEPTS INC3 | 75 SOUTH BROADWAY WHITE PLAINS, NY 10601 | THE PAUL REVERE LIFE INSURANCE COMPANY | $191 | $0 | $191 | 0.59% |
| WENDY ELIZABETH WESOLOWSKI3 Filed as: WENDY WESOLOWSKI | 1284 NORTH 12TH AVENUE PENSACOLA, FL 32503 | THE PAUL REVERE LIFE INSURANCE COMPANY | $11 | $0 | $11 | 0.03% |
| STERLING AND STERLING, INC.3 Filed as: STERLING & STERLING LLC | 135 CROSSWAYS PARK DRIVE, SUITE 300 WOODBURY, NY 11797 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $77 | $0 | $77 | 2.64% |
| WENDY ELIZABETH WESOLOWSKI3 Filed as: WENDY WESOLOWSKI | 1284 NORTH 12TH AVENUE PENSACOLA, FL 32503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $45 | $0 | $45 | 1.54% |
| JNAZ INC3 | 145 MIDDLEVILLE ROAD NORTHPORT, NY 11768 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 1.51% |
| MICHELLE DARTEE3 | PO BOX 274 SPARTA, NJ 07871 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | $0 | $29 | 0.99% |
| CLARICE R MIMS3 Filed as: CLARICE MIMS | 17290 HIGHLAND AVENUE, APARTMENT 2B JAMAICA, NY 11432 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.21% |
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 | 220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 396 | $3.4M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 396 | $3.4M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 396 | $3.4M |
| Life insurance(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 238 | $220K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 238 | $137K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 238 | $137K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 396 | $3.4M |
| Other(3 contracts, 3 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 238 | $172K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 396 | — |
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.