| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ONEGROUP NY INC3 | 706 N CLINTON STREET ONCEGROUP CENTER SYRACUSE, NY 13204 | CIGNA | $11K | $131K | $142K | 5.44% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BOULEVARD 2ND FLOOR HAUPPAUGE, NY 11788 | CIGNA | $0 | $55K | $55K | 2.08% |
| ONEGROUP NY INC3 | 706 N CLINTON STREET ONCEGROUP CENTER SYRACUSE, NY 13204 | GUARDIAN INSURANCE | $3K | $0 | $3K | 5.66% |
| ONEGROUP NY INC3 | 706 N CLINTON STREET ONCEGROUP CENTER SYRACUSE, NY 13204 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $3K | $0 | $3K | 7.83% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BOULEVARD SUITE 200 HAUPPAUGE, NY 11788 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $0 | $3K | $3K | 7.66% |
| ONEGROUP NY INC3 | 706 N CLINTON STREET ONCEGROUP CENTER SYRACUSE, NY 13204 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $3K | $0 | $3K | 12.92% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BOULEVARD SUITE 200 HAUPPAUGE, NY 11788 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $0 | $2K | $2K | 7.89% |
| EMERY TYLER3 | 78 HUDSON DR BAY SHORE, NY 11706 | AFLAC | $439 | $0 | $439 | 2.76% |
| JANELLE M GADOMSKI3 | 48 FAIRVIEW AVE PARK RIDGE, NJ 07656 | AFLAC | $270 | $64 | $334 | 2.10% |
| JOHN E GLASER3 | 85 ARLINGTON RD LAKE RONKONKOMA, NY 11779 | AFLAC | $281 | $0 | $281 | 1.77% |
| DAVID CAPO3 | 2413 WOOD AVENUE BELLMORE, NY 11710 | AFLAC | $227 | $0 | $227 | 1.43% |
| ONEGROUP NY INC3 | 706 N CLINTON STREET ONCEGROUP CENTER SYRACUSE, NY 13204 | AFLAC | $220 | $0 | $220 | 1.38% |
| MICHAEL PASQUALY DESTEFANO3 Filed as: MICHAEL DESTEFANO | 4250 VETERANS MEMORIAL HIGHWAY SUITE 1015W HOLBROOK, NY 11741 | AFLAC | $218 | $0 | $218 | 1.37% |
| SILVIA DESTEFANO3 | 4250 VETERANS MEMORIAL HIGHWAY SUITE 1015W HOLBROOK, NY 11741 | AFLAC | $104 | $0 | $104 | 0.65% |
| DOMENICO V MAUTARELLI3 | PO BOX 767 MATTITUCK, NY 11952 | AFLAC | $103 | $0 | $103 | 0.65% |
| JACQUES P DAVID CORPORATION3 | 35 PINELAWN RD SUITE 190 MELVILLE, NY 11747 | AFLAC | $83 | $0 | $83 | 0.52% |
| GARY DESTEFANO3 | 23 LEHIGH DR SMITHTOWN, NY 11787 | AFLAC | $74 | $0 | $74 | 0.46% |
| JAMES (JAY) GRIMES3 Filed as: JAMES GRIMES | 6165 WATERFORD RD COLUMBUS, OH 31904 | AFLAC | $66 | $0 | $66 | 0.41% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C MWIER CORP | 19 MARKWOOD RD GARDEN CIOTY, NY 11530 | AFLAC | $64 | $0 | $64 | 0.40% |
| PATRICK RUHLE3 Filed as: PATRICK C HARDIE | 14 WALL STREET SUITE 8C NEW YORK, NY 10005 | AFLAC | $37 | $11 | $48 | 0.30% |
| BRADLEY S RUPPEL3 | 67 MAPLE PL HUNTINGTON, NY 11743 | AFLAC | $39 | $0 | $39 | 0.24% |
| MICHAEL S CHILLE3 Filed as: MICHAEL D CHILLE | 12 ST THOMAS MORE DR WINCHESTER, ME 01890 | AFLAC | $38 | $0 | $38 | 0.24% |
| BRIEN C FLETCHER3 | 15 GARDEN AVE CARLE PLACE, NY 11514 | AFLAC | $15 | $0 | $15 | 0.09% |
| THOMAS G GIORDANO3 | 139 CONCORD AVE OCEANSIDE, NY 11572 | AFLAC | $10 | $0 | $10 | 0.06% |
| BRIAN WHITE3 | 6 COWDIN LANE CHAPPAQUA, NY 10514 | AFLAC | $9 | $0 | $9 | 0.06% |
| MCINERNEY GROUP LLC3 | 580 WHITE PLAINS RD SUITE 115 TARRYTOWN, NY 10591 | AFLAC | $7 | $0 | $7 | 0.04% |
| BENITO A ROTONDI II INC3 | 23 PINE RIDGE RD SARATOGA SPRINGS, NY 12866 | AFLAC | $6 | $0 | $6 | 0.04% |
| WILLIAM J LOEFFERT3 Filed as: WILLIAM J. LOEFFERT | 545 DAVIS ST NORTH BABYLON, NY 11703 | AFLAC | $5 | $0 | $5 | 0.03% |
| GALE LOEFFERT3 | 545 DAVIS ST NORTH BABYLON, NY 11703 | AFLAC | $5 | $0 | $5 | 0.03% |
| TODD J BURKE CORP3 Filed as: TODD J. BURKE CORP | 40 MAXWELL RD GARDEN CITY, NY 11530 | AFLAC | $2 | $0 | $2 | 0.01% |
| ONEGROUP NY INC3 | 706 N CLINTON STREET ONCEGROUP CENTER SYRACUSE, NY 13204 | FIRST UNUM L.IFE INSURANCE COMPANY | $313 | $0 | $313 | 2.50% |
| LISA BETH BEERS3 | 3630 GARDENS PARKWAY UNIT 1003 PALM BEACH GARDENS, FL 33410 | FIRST UNUM L.IFE INSURANCE COMPANY | $57 | $0 | $57 | 0.46% |
| ONEGROUP NY INC3 | 706 N CLINTON STREET ONCEGROUP CENTER SYRACUSE, NY 13204 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.79% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS LLC. | BDA PREMIER WORKSITE B 700 KINDERLAMACK RD ST ORADELL, NJ 07649 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 8.48% |
| VINCENZO VENTURI3 | 14 WESTCHESTER AVENUE POUND RIDGE, NY 10576 | FIRST UNUM L.IFE INSURANCE COMPANY | $2K | $0 | $2K | 20.18% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS LLC. | 700 KINDERLAMACK RD ST ORADELL, NJ 07649 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $1K | $0 | $1K | 11.05% |
| ONEGROUP NY INC3 | 706 N CLINTON STREET ONCEGROUP CENTER SYRACUSE, NY 13204 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $541 | $0 | $541 | 5.95% |
| MATTHEW BORELLA3 | PREMIER WORKSITE SOLUTIONS LLC. 700 KINDERLAMACK RD ST ORADELL, NJ 07649 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $95 | $0 | $95 | 1.04% |
| ONEGROUP NY INC3 | 706 N CLINTON STREET ONCEGROUP CENTER SYRACUSE, NY 13204 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $340 | $0 | $340 | 12.02% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BOULEVARD SUITE 200 HAUPPAUGE, NY 11788 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $0 | $218 | $218 | 7.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 INSURANCE PROVIDER | Other insurance fees and expenses Service code 73 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $123K |
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 | 316 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 239 | $2.6M |
| Dental | CIGNA | 239 | $2.6M |
| Vision | CIGNA | 239 | $2.6M |
| Life insurance(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 190 | $47K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN INSURANCE | 316 | $62K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 10 | $26K |
| Other(7 contracts, 5 carriers) | GUARDIAN INSURANCE | 316 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.