| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREMIER BENEFIT PLANS INC3 | 35 PINELAWN ROAD SUITE 208E MELVILLE, NY 11747 | UNITEDHEALTHCARE INSURANCE COMPANY | $40K | — | $40K | 3.00% |
| PREMIER BENEFIT PLANS INC3 | 35 PINELAWN ROAD MELVILLE, NY 11747 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4K | — | $4K | 6.97% |
| SOTERIA PARTNERS LLC3 | 4 CENTURY DRIVE PARSIPPANY, NJ 07054 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $118 | $2K | 3.76% |
| CDC CONSULTING SERVICES INC3 | 47 WESTERN AVENUE DEER PARK, NY 11729 | THE PAUL REVERE LIFE INSURANCE COMPANY | $712 | — | $712 | 1.12% |
| JUSTIN CLARK ETTS3 | 1903 GREVE AVENUE SPRING LAKE, NJ 07762 | THE PAUL REVERE LIFE INSURANCE COMPANY | $367 | $38 | $405 | 0.63% |
| EDWARD P DOUGHERTY INC3 | 4550 PRESTWICK DRIVE READING, PA 19606 | THE PAUL REVERE LIFE INSURANCE COMPANY | $192 | — | $192 | 0.30% |
| MARLON ANTHONY MILLER3 | 1843 WIMBLEDON STREET KISSIMMEE, FL 34743 | THE PAUL REVERE LIFE INSURANCE COMPANY | $143 | — | $143 | 0.22% |
| AMARILIS ALTAGRACIA CSIKORTOS3 | 480 CREEK TERRACE DRIVE SAGINAW, TX 76131 | THE PAUL REVERE LIFE INSURANCE COMPANY | $123 | — | $123 | 0.19% |
| KIMANI MATTHEW3 | 52 CANTON ROAD WEST SIMSBURY, CT 06092 | THE PAUL REVERE LIFE INSURANCE COMPANY | $59 | — | $59 | 0.09% |
| MARIA MULLER3 | 495 WINDEMERE AVENUE MT ARLINGTON, NJ 07856 | THE PAUL REVERE LIFE INSURANCE COMPANY | $22 | — | $22 | 0.03% |
| PREMIER BENEFIT PLANS INC3 | 35 PINELAWN ROAD SUITE 208E MELVILLE, NY 11747 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 5.68% |
| PREMIER BENEFIT PLANS INC3 | 35 PINELAWN ROAD SUITE 208E MELVILLE, NY 11747 | COMPANION LIFE INSURANCE COMPANY | $2K | $703 | $2K | 14.44% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | COMPANION LIFE INSURANCE COMPANY | — | $312 | $312 | 1.97% |
| PREMIER BENEFIT PLANS INC3 | 35 PINELAWN ROAD SUITE 208E MELVILLE, NY 11747 | UNITEDHEALTHCARE INSURANCE COMPANY | $734 | — | $734 | 10.09% |
| PREMIER BENEFIT PLANS INC3 | 35 PINELAWN ROAD SUITE 208E MELVILLE, NY 11747 | FIRST UNUM LIFE INSURANCE COMPANY | $768 | — | $768 | 14.99% |
| PREMIER BENEFIT PLANS INC3 | — | TELADOC | $673 | — | $673 | 15.00% |
| PREMIER BENEFIT PLANS INC3 | 35 PINELAWN ROAD SUITE 208E MELVILLE, NY 11747 | MUTUAL OF OMAHA INSURANCE COMPANY | $253 | $112 | $365 | 14.43% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $50 | $50 | 1.98% |
| PREMIER BENEFITS PLANS INC3 | 35 PINELAWN ROAD SUITE 208E MELVILLE, NY 11747 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $160 | — | $160 | 6.83% |
| A SECURE YOU INC3 | 63 SABLE RUN EAST AMHERST, NY 14051 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $146 | — | $146 | 6.23% |
| JACK SOARES II3 | 28 ONEIDA STREET NEW BRITIAN, CT 06053 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $20 | — | $20 | 0.85% |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 188 | $1.3M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 177 | $59K |
| Vision(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 177 | $66K |
| Life insurance(3 contracts, 3 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 180 | $82K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 15 | $5K |
| Other(5 contracts, 5 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 180 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.