| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STAR RISK SERVICES, INC.3 Filed as: STAR RISK SERVICES INC | 536 SILICON DR STE 103 SOUTHLAKE, TX 760929020 | VISION SERVICE PLAN | $15K | — | $15K | 10.00% |
| WILLIAM WHICHER3 Filed as: WILLIAM H WHICHER | 1 LINDEN ST GARDEN CITY, NY 11530 | AFLAC | $274 | — | $274 | 1.61% |
| PATRICK RUHLE3 | RUHLE RISK MANAGEMENT 200 GARDEN CITY PLZ STE 410 GARDEN CITY, NY 11530 | AFLAC | $183 | — | $183 | 1.07% |
| RICHARD F ROTHSCHILD3 | 125 2ND STREET C-1 GARDEN CITY, NY 11530 | AFLAC | $181 | — | $181 | 1.06% |
| KENNETH C MEIER CORP3 | 401 FRANKLIN AVENUE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $170 | — | $170 | 1.00% |
| CHRISTOPHER TARI3 | 4047 PARKSIDE DRIVE SEAFORD, NY 11783 | AFLAC | $105 | — | $105 | 0.62% |
| RECRUITER MMNY INC3 Filed as: RECRUITER MMNY INC. | 3810 JERUSALEM AVE SEAFORD, NY 11783 | AFLAC | $66 | — | $66 | 0.39% |
| RICHARD F ROTHSCHILD3 | 125 2ND ST C-1 GARDEN CITY, NY 11530 | AFLAC | $419 | $127 | $546 | 4.72% |
| WILLIAM WHICHER3 Filed as: WILLIAM H WHICHER | 1 LINDEN ST GARDEN CITY, NY 11530 | AFLAC | $343 | $42 | $385 | 3.33% |
| CHRISTOPHER TARI3 | 4047 PARKSIDE DR SEAFORD, NY 11783 | AFLAC | $255 | $85 | $340 | 2.94% |
| PATRICK RUHLE3 | RUHLE RISK MANAGEMENT 200 GARDEN CITY PLAZA SUITE 410 GARDEN CITY, NY 11530 | AFLAC | $200 | $42 | $242 | 2.09% |
| KENNETH C MEIER CORP3 | 401 FRANKLIN AVE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $124 | $42 | $166 | 1.44% |
| RECRUITER MMNY INC3 | 3810 JERUSALEM AVE SEAFORD, NY 11783 | AFLAC | $58 | — | $58 | 0.50% |
| BRENTLEY HUXTABLE3 | 2606 E CHURCH ST ORLANDO, FL 32803 | AFLAC | $128 | — | $128 | 2.20% |
| NANCY K BLOCKER3 Filed as: NANCY K MACKEY | 3631 E 48TH PL TULSA, OK 74135 | AFLAC | $80 | — | $80 | 1.38% |
| DENNY P. TWIGG3 Filed as: DENNY P TWIGG | 16800 DEVONSHIRE ST STE 220 GRANADA HILLS, CA 91344 | AFLAC | $43 | — | $43 | 0.74% |
| DAVID L DEARDORFF3 | 9083 E 138TH ST S BIXBY, OK 74008 | AFLAC | $42 | — | $42 | 0.72% |
| OMER S BASS IV3 | 565 W GATEAY CT MERRITT ISLAND, FL 32952 | AFLAC | $32 | — | $32 | 0.55% |
| RAND G SIMKINS3 | 1237 SHAWNEE TRL CARROLLTON, TX 75007 | AFLAC | $27 | — | $27 | 0.46% |
| JOHN ROBERT DE LARIOS3 | 4306 W TOLEDO CT BROKEN ARROW, OK 74012 | AFLAC | $21 | — | $21 | 0.36% |
| THE PERRY GROUP INC3 | 1650 SAND LAKE RD SUITE 201D ORLANDO, FL 32809 | AFLAC | $21 | — | $21 | 0.36% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C MEIER | 401 FRANKLIN AVE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $17 | — | $17 | 0.29% |
| MKF & ASSOCIATES INC3 Filed as: MKF & ASSOCIATES INC. | 4505 PINE TREE CIR STE 201 BIRMINGHAM, AL 35243 | AFLAC | $15 | — | $15 | 0.26% |
| LARRY D DENNY3 | PO BOX 306 WETUMKA, OK 74883 | AFLAC | $11 | — | $11 | 0.19% |
| OLENA K SHEA3 | 1502 BROADWAY UNIT 308 SANTA MONICA, CA 90404 | AFLAC | $7 | — | $7 | 0.12% |
| PATRICK R RUHLE3 | 200 GARDEN CITY PLAZA STE 410 GARDEN CITY, NY 11530 | AFLAC | $6 | — | $6 | 0.10% |
| BARBARA ANN MCNAUGHTON3 | 29622 N 21ST DR PHOENIX, AZ 85085 | AFLAC | $6 | — | $6 | 0.10% |
| SANDRA VELAZQUEZ3 | 2540 SW 7TH AVE MIAMI, FL 33129 | AFLAC | $5 | — | $5 | 0.09% |
| ADAM H MICHAELS3 | 12121 WILSHIRE BLVD STE 1225 LOS ANGELES, CA 90025 | AFLAC | $4 | — | $4 | 0.07% |
| MARIA C ORTIZ3 | 7400 SW 50 TR SUITE 300 MIAMI, FL 33155 | AFLAC | $3 | — | $3 | 0.05% |
| MARTA M SASTRE3 | PO BOX 140127 CORAL GABLES, FL 33114 | AFLAC | $2 | — | $2 | 0.03% |
| ROBERT PERRY EVANS JR3 | 1031 SADDLEBROOK DR LUCAS, TX 75002 | AFLAC | $1 | — | $1 | 0.02% |
| ALFRED RIETKERK3 | 3120 NE 47TH ST FORT LAUDERDALE, FL 33308 | AFLAC | $1 | — | $1 | 0.02% |
| ROBERT S ZEMAN3 | 37 DERRYFIELD CT MANCHESTER, NH 03104 | AFLAC | $66 | — | $66 | 1.76% |
| MARGARET R WINTERS3 | 6014 GIESEKE DRIVE CRYSTAL LAKE, IL 60014 | AFLAC | $58 | — | $58 | 1.55% |
| STEVEN R KARAS3 | 29 CRAFTS STREET STE 550 NEWTON, MA 02458 | AFLAC | $53 | — | $53 | 1.42% |
| SHANDA L FERNANDEZ3 | 4378 W 138TH ST APT 5 HAWTHRONE, CA 90250 | AFLAC | $41 | — | $41 | 1.10% |
| ROBERT S ZEMAN3 | 154 FLAGSTONE DR APT 12 NASHUA, NH 03063 | AFLAC | $33 | — | $33 | 0.88% |
| KAREN TUCCI3 | 73 STETSON DR MARLBOROUGH, MA 01752 | AFLAC | $29 | — | $29 | 0.78% |
| STEVEN R HANSON3 | 340 E 2ND STREET SUITE 310 LOS ANGELES, CA 90012 | AFLAC | $22 | — | $22 | 0.59% |
| JODY D WINTERS3 | 6014 GIESEKE DR CRYSTAL LAKE, IL 60014 | AFLAC | $14 | — | $14 | 0.37% |
| DANIEL P CLARK3 | 33 LANDAU ROAD PLAINVILLE, MA 02762 | AFLAC | $13 | — | $13 | 0.35% |
| DON J CONOYER3 | 303 HOGUE LN WYLIE, TX 75098 | AFLAC | $12 | — | $12 | 0.32% |
| PACIFIC FIN INST MKT3 | 92-1082 OLANI ST APT 2 KAPOLEI, HI 96707 | AFLAC | $11 | — | $11 | 0.29% |
| JR AND COOPER INC3 | 611 IRONWOOD CT APT B1 WHEELING, IL 60090 | AFLAC | $7 | — | $7 | 0.19% |
| CHAD L NELSON3 Filed as: CHAD NELSON | 490 EAST ROOSEVELT ROAD STE 203 WEST CHICAGO, IL 60185 | AFLAC | $4 | — | $4 | 0.11% |
| WILLIAM WHICHER3 | 1 LINDEN ST GARDEN CITY, NY 11530 | AFLAC | $3 | — | $3 | 0.08% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C MEIER | 401 FRANKLIN AVENUE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $3 | — | $3 | 0.08% |
| TODD V MASON3 | 6164 LAWRENCE ST CYPRESS, CA 90630 | AFLAC | $2 | — | $2 | 0.05% |
| PATRICK R RUHLE3 | 200 GARDEN CITY PLAZA SUITE 410 GARDEN CITY, NY 11530 | AFLAC | $2 | — | $2 | 0.05% |
| MARIA C ORTIZ3 Filed as: MARIA C. ORTIZ | 7400 SW 50TH TERR STE 300 MIAMI, FL 33155 | AFLAC | $1 | — | $1 | 0.03% |
| LISETTTE M. HERNANDEZ3 | 10121 NORTHGOLDEN ELM DR ESTERO, FL 33155 | AFLAC | $1 | — | $1 | 0.03% |
| MARTA M SASTRE3 Filed as: MARTA M. SASTRE | P O BOX 140127 CORAL GABLES, FL 33114 | AFLAC | $1 | — | $1 | 0.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 NONE | Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Float revenue; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $695K |
| DELTA DENTAL OF NY EIN 11-1980218 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $72K |
| BENEFITS MANAGEMENT SOLUTIONS EIN 11-3516037 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $67K |
| RESPONSEWORKS, INC. EIN 22-3563649 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $32K |
| WAGNER & ZWERMAN LLP EIN 11-2836481 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $15K |
| CIGNA | Contract Administrator; Direct payment from the plan; Other services; Participant communication; Claims processing; Non-monetary compensation; Named fiduciary; Float revenue Service code 12 | — | $0 |
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 | 1,159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 123 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 69 | $744K |
| Vision | VISION SERVICE PLAN | 913 | $146K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,417 | $966K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,417 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.