| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KINLOCH CONSULTING GROUP, INC. | 25 MELVILLE PARK ROAD SUITE 260 MELVILLE, NY 11747 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $50K | — | $50K | 2.73% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KINLOCH CONSULTING GROUP, INC. | 25 MELVILLE PARK ROAD SUITE 260 MELVILLE, NY 11747 | BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND | $10K | — | $10K | 2.46% |
| DOMENICO V MAUTARELLI3 Filed as: DOMENICO V. MAUTARELLI | PO BOX 767 MATTITUCK, NY 11952 | AFLAC | $8K | $57 | $8K | 4.78% |
| MICHAEL C WALKER3 Filed as: MICHAEL P. DESTEFANO | 4250 VETERANS MEMORIAL HWY,STE 1015 HOLBROOK, NY 11741 | AFLAC | $4K | $12 | $4K | 2.35% |
| GERARD J. HEINGARTNER3 | PO BOX 180 HOLBROOK, NY 11741 | AFLAC | $2K | — | $2K | 1.21% |
| MICHAEL PASQUALY DESTEFANO3 | 4250 VETERANS MEMORIAL HWY,STE 1015 HOLBROOK, NY 11741 | AFLAC | $2K | $12 | $2K | 0.92% |
| SILVIA DESTEFANO3 | 4250 VETERANS MEMORIAL HWY,STE 1015 HOLBROOK, NY 11741 | AFLAC | $2K | — | $2K | 0.89% |
| KENNETH C MEIER CORP3 | 401 FRANKLIN AVE, STE 312 GARDEN CITY, NY 11530 | AFLAC | $1K | $11 | $1K | 0.68% |
| GARRY HOFFMANN3 Filed as: GARRY P. HOFFMANN | PO BOX 482 SHOREHAM, NY 11786 | AFLAC | $1K | — | $1K | 0.60% |
| JAMES (JAY) GRIMES3 | 6165 WATERFORD ROAD COLUMBUS, GA 31904 | AFLAC | $938 | — | $938 | 0.55% |
| BENEDETTO V. CRACCO3 | 36 MUNSON COURT MELVILLE, NY 11747 | AFLAC | $578 | — | $578 | 0.34% |
| MICHAEL S CHILLE3 Filed as: MICHAEL S. CHILLE | 22 CORPORATE WOODS BOULEVARD 4TH FL ALBANY, NY 12211 | AFLAC | $492 | — | $492 | 0.29% |
| KEITH EDWARD DEGMAYR3 | 678 FLANDERS ROAD FLANDERS, NY 11901 | AFLAC | $308 | — | $308 | 0.18% |
| ROSELLE BORRELLI3 | 519 1ST STREET GREENPORT, NY 11944 | AFLAC | $190 | — | $190 | 0.11% |
| WILLIAM J LOEFFERT3 Filed as: WILLIAM J. LOEFFERT | 555 BROAD HOLLOW RD SUITE 201 MELVILLE, NY 11747 | AFLAC | $99 | — | $99 | 0.06% |
| NEEFUS STYPE AGENCY, INC.3 | 711 UNION AVENUE, PO BOX 2340 AQUEBOGUE, NY 11931 | AFLAC | $91 | — | $91 | 0.05% |
| ALLAN H. MARKOWITZ3 | 17 LINDSEY PLACE HOLBROOK, NY 11741 | AFLAC | $51 | — | $51 | 0.03% |
| THE FARMINGTON COMPANY3 Filed as: FARMINGTON COMPANY | 30 WATERSIDE DRIVE FARMINGTON, CT 06034 | AFLAC | $45 | — | $45 | 0.03% |
| ROBERT BLUME3 Filed as: ROBERT A. KUSTEK | 12 BAXTER AVENUE NEW HYDE PARK, NY 11040 | AFLAC | $35 | — | $35 | 0.02% |
| PAUL J. LIBERATORE3 | 121 MOCKINGBIRD LANE DELRAY BEACH, FL 33445 | AFLAC | $31 | — | $31 | 0.02% |
| GARY DESTEFANO3 | 23 LEHIGH DRIVE SMITHTOWN, NY 11787 | AFLAC | $16 | — | $16 | 0.01% |
| LOUIS R FAIOLA3 Filed as: LOUIS R. FAIOLA | 12 HAAWK COURT DELMAR, NY 12054 | AFLAC | $4 | — | $4 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KINLOCH CONSULTING GROUP, INC. | 25 MELVILLE PARK ROAD SUITE 260 MELVILLE, NY 11747 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $5K | — | $5K | 3.18% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KINLOCH CONSULTING GROUP, INC. | 25 MELVILLE PARK ROAD SUITE 260 MELVILLE, NY 11747 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $6K | — | $6K | 10.09% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KINLOCH CONSULTING GROUP, INC. | 25 MELVILLE PARK ROAD SUITE 260 MELVILLE, NY 11747 | BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND | $1K | — | $1K | 5.01% |
| DOMENICO V MAUTARELLI3 Filed as: DOMENICO V. MAUTARELLI | PO BOX 767 MATTITUCK, NY 11952 | AFLAC | $492 | — | $492 | 5.82% |
| MICHAEL PASQUALY DESTEFANO3 | 4250 VETERANS MEMORIAL HWY,STE 1015 HOLBROOK, NY 11741 | AFLAC | $238 | — | $238 | 2.82% |
| MICHAEL C WALKER3 Filed as: MICHAEL P. DESTEFANO | 4250 VETERANS MEMORIAL HWY,STE 1015 HOLBROOK, NY 11741 | AFLAC | $123 | — | $123 | 1.46% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C. MEIER | 401 FRANKLIN AVENUE, STE 312 GARDEN CITY, NY 11530 | AFLAC | $61 | — | $61 | 0.72% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: KINLOCH CONSULTING GROUP, INC. | 25 MELVILLE PARK ROAD SUITE 260 MELVILLE, NY 11747 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $89 | — | $89 | 2.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 ADMINISTRATOR | Contract Administrator Service code 13 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 462044903 | $19K |
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 | 311 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 200 | $2.2M |
| Dental(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 219 | $182K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 200 | $3K |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 311 | $64K |
| Other(3 contracts, 2 carriers) | AFLAC | 311 | $244K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.