| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MY BENEFIT ADVISOR LLC3 | PO BOX 333 WESTBURY, NY 11590 | EMPIRE HEALTHCHOICE ASSURANCE INC | $46K | $0 | $46K | 3.27% |
| EMERSON REID LLC3 Filed as: EMERSON REID & COMPANY INC | 400 POST AVE WESTBURY, NY 11590 | EMPIRE HEALTHCHOICE ASSURANCE INC | $0 | $18K | $18K | 1.26% |
| JULIE ANN KLIMCHAK3 | 7 VANNINA PLACE HUNTINGTON, NY 11743 | THE PAUL REVERE LIFE INSURANCE COMPANY | $842 | $0 | $842 | 8.32% |
| JOHN R KLIMCHAK3 | 7 VANNINA PL HUNTINGTON, NY 11743 | THE PAUL REVERE LIFE INSURANCE COMPANY | $576 | $0 | $576 | 5.69% |
| JNAZ INC3 | 145 MIDDLEVILLE ROAD NORTHPORT, NY 11768 | THE PAUL REVERE LIFE INSURANCE COMPANY | $115 | $4 | $119 | 1.18% |
| CATHERINE MONTELEONE3 | 7 NORMANDY COURT COMMACK, NY 11725 | THE PAUL REVERE LIFE INSURANCE COMPANY | $17 | $0 | $17 | 0.17% |
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 | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE INC | 118 | $1.4M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE INC | 118 | $1.4M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE INC | 118 | $1.4M |
| Life insurance(3 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 95 | $0 |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 106 | $0 |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 63 | $0 |
| Other(3 contracts, 2 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 95 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 118 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.