| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KRISTEN PARZIANO3 | 15 10TH STREET STATEN ISLAND, NY 10306 | AFLAC | $5K | $464 | $6K | 3.45% |
| MICHAEL S TEITELBAUM3 | 4023 W SAN PEDRO STREET TAMPA, FL 33829 | AFLAC | $4K | $96 | $4K | 2.42% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY A LIBECCI | 4864 ARTHUR KILL ROAD SUITE 3 STATEN ISLAND, NY 10309 | AFLAC | $4K | $131 | $4K | 2.36% |
| JACQUELINE CASTRO3 Filed as: JACQUELINE S CASTRO LLC | 131 E 39TH STREET APT 3 NEW YORK, NY 10016 | AFLAC | $2K | — | $2K | 1.32% |
| YANIRA TEITELBAUM3 | 4023 W SAN PEDRO STREET TAMPA, FL 33629 | AFLAC | $2K | — | $2K | 1.20% |
| PATRICK RUHLE3 Filed as: PATRICK C HARDIE | 14 WALL STREET SUITE 8C NEW YORK, NY 10005 | AFLAC | $2K | $131 | $2K | 1.04% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY R ORGERA INC | 14 WALL STREET SUITE 8C NEW YORK, NY 10005 | AFLAC | $1K | — | $1K | 0.84% |
| PEARLAND BROKERAGE INC3 | 3601 43RD AVENUE FLOOR 1 LONG ISLAND CITY, NY 11101 | AFLAC | $1K | — | $1K | 0.61% |
| KENNETH C MEIER CORP3 | 19 MARKWOOD ROAD GARDEN CITY, NY 11530 | AFLAC | $410 | — | $410 | 0.24% |
| TREVOR FENNELL3 | 7 HIGHLAND LANE EAST HAMPTON, NY 11937 | AFLAC | $358 | — | $358 | 0.21% |
| TIMOTHY C CAVAZOS3 | 11551 NUCKOLS ROAD SUITE P GLEN ALLEN, VA 23059 | AFLAC | $337 | — | $337 | 0.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: KEVIN G GALLAGHER | 2640 LAKE SHORE DRIVE UNIT 411 RIVIERA BEACH, FL 33404 | AFLAC | $285 | — | $285 | 0.17% |
| SPAOLILLO CORP3 | 615 RIDGE AVE APT 1F BROOKLYN, NY 11220 | AFLAC | $239 | — | $239 | 0.14% |
| CHARLES J MULE3 | 147 UNION STREET BROOKLYN, NY 11231 | AFLAC | $155 | — | $155 | 0.09% |
| BRIAN WHITE3 | 6 COWDIN LANE CHAPPAQUA, NY 10514 | AFLAC | $104 | — | $104 | 0.06% |
| BENITO A ROTONDI II INC3 | 23 PINE RIDGE ROAD SARATOGA SPRINGS, NY 12866 | AFLAC | $93 | — | $93 | 0.05% |
| DENNIS FENNELL3 | 8 BELVOIR DRIVE WASHINGTONVILLE, NY 10992 | AFLAC | $62 | — | $62 | 0.04% |
| KWAN CHAE3 | 395 SOUTH END AVENUE 8J NEW YORK, NY 10280 | AFLAC | $36 | — | $36 | 0.02% |
| MICHAEL S CHILLE3 | 12 ST THOMAS MORE DRIVE WINCHESTER, MA 01890 | AFLAC | $23 | — | $23 | 0.01% |
| TODD J BURKE CORP3 | 40 MAXWELL ROAD GARDEN CITY, NY 11530 | AFLAC | $18 | — | $18 | 0.01% |
| ANGELA MONTENEGRO3 | 74 HILLANDALE DRIVE NEW ROCHELLE, NY 10804 | AFLAC | $14 | — | $14 | 0.01% |
| STEPHEN WHITE3 Filed as: STEPHEN P WHITE | 5 EMERALD LANE MONTEBELLO, NY 10901 | AFLAC | $8 | — | $8 | 0.00% |
| KERRY E MANGIACASALE3 | 24 PILCHER STREET STATEN ISLAND, NY 10314 | AFLAC | $8 | — | $8 | 0.00% |
| THE MEYER AGENCY LTD3 | PO BOX 112829 NAPLES, FL 34108 | AFLAC | $6 | — | $6 | 0.00% |
| MCINERNEY GROUP LLC3 | 580 WHITE PLAINS ROAD SUITE 115 TARRYTOWN, NY 10591 | AFLAC | $5 | — | $5 | 0.00% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DRIVE SE CALENDONIA, MI 49316 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 6.21% |
| ACRISURE LLC3 | 16 WEST 36TH STREET 11TH FLOOR NEW YORK, NY 10018 | GUARDIAN | $1K | $38 | $1K | 9.55% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | FIRST UNUM LIFE INSURANCE COMPANY | $504 | $26 | $530 | 15.52% |
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 | 1 | 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) | 1 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 0 | $63K |
| Vision | GUARDIAN | 98 | $11K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 14 | $3K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 14 | $3K |
| Other(2 contracts, 2 carriers) | AFLAC | 14 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 98 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.