| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUBICON BENEFITS LLC3 | 718 WALT WHITMAN RD #1568 MELVILLE, NY 11747 | EMPIRE HEALTHCHOICE ASSURANCE INC | $55K | $0 | $55K | 3.50% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FIN SVCS | 12404 PARK CENTRAL DR SUITE 400S DALLAS, TX 75251 | EMPIRE HEALTHCHOICE ASSURANCE INC | $0 | $19K | $19K | 1.23% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: WORLD INSURANCE ASSOCIATES | 100 WOOD AVENUE SOUTH 4TH FLOOR ISELIN, NJ 08830 | EMPIRE HEALTHCHOICE ASSURANCE INC | $5K | $0 | $5K | 0.33% |
| MARK EDWARDS3 | 15 MARION STREET EAST BRUNSWICK, NJ 08816 | EMPIRE HEALTHCHOICE ASSURANCE INC | -$1 | $0 | -$1 | -0.00% |
| RUBICON BENEFITS LLC3 Filed as: RUBICON BENEFITS | RUBICON BENEFITS MELVILLE, NY 11747 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $13K | $5K | $18K | 17.43% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS BROKERS (LIST ATTACHED) | — | AFLAC | $7K | $0 | $7K | 50.05% |
| JENNIFER E LUBELSKY3 | 80 JOHN ST APT 11C NEW YORK, NY 10038 | AFLAC | $1K | $0 | $1K | 36.04% |
| JASON SALLEMI3 | 302 MONROE ST APT 4B HOBOKEN, NJ 07030 | AFLAC | $369 | $0 | $369 | 8.88% |
| SHAUN T KONIOR3 | 31 STRATFORD GRN FARMINGDALE, NY 11735 | AFLAC | $238 | $0 | $238 | 5.73% |
| JULIE ANN KLIMCHAK3 | 7 VANNINA PLACE HUNTINGTON, NY 11743 | THE PAUL REVERE LIFE INSURANCE COMPANY | $126 | $0 | $126 | 4.01% |
| JNAZ INC3 | 145 MIDDLEVILLE ROAD NORTHPORT, NY 11768 | THE PAUL REVERE LIFE INSURANCE COMPANY | $14 | $0 | $14 | 0.45% |
| CATHERINE MONTELEONE3 | 7 NORMANDY COURT COMMACK, NY 11725 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.10% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS BROKERS (LIST ATTACHED) | — | AFLAC | $1K | $0 | $1K | 49.10% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS BROKERS (LIST ATTACHED) | — | AFLAC | $218 | $0 | $218 | 46.09% |
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 | 183 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE INC | 154 | $1.6M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE INC | 154 | $1.6M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE INC | 154 | $1.6M |
| Life insurance(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 177 | $104K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 177 | $102K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 177 | $102K |
| Other(6 contracts, 3 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 177 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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.