| 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 | $16K | — | $16K | 10.00% |
| WILLIAM WHICHER3 Filed as: WILLIAM H WHICHER | 1 LINDEN ST GARDEN CITY, NY 11530 | AFLAC | $385 | — | $385 | 2.04% |
| CHRISTOPHER TARI3 | 4047 PARKSIDE DRIVE SEAFORD, NY 11783 | AFLAC | $340 | — | $340 | 1.80% |
| RICHARD F ROTHSCHILD3 | 125 2ND STREET C-1 GARDEN CITY, NY 11530 | AFLAC | $299 | — | $299 | 1.58% |
| PATRICK RUHLE3 | RUHLE RISK MANAGEMENT 200 GARDEN CITY PLZ STE 410 GARDEN CITY, NY 11530 | AFLAC | $259 | — | $259 | 1.37% |
| KENNETH C MEIER CORP3 | 401 FRANKLIN AVENUE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $175 | — | $175 | 0.93% |
| JAMES ROBERT CONFORT3 Filed as: JAMES CONFORT | 141 OXFORD BLVD GARDEN CITY, NY 11530 | AFLAC | $110 | — | $110 | 0.58% |
| RECRUITER MMNY INC3 Filed as: RECRUITER MMNY INC. | 3810 JERUSALEM AVE SEAFORD, NY 11783 | AFLAC | $72 | — | $72 | 0.38% |
| TRACY MCCULLOCH3 | 1735 GORMLEY AVE MERRICK, NY 11566 | AFLAC | $26 | — | $26 | 0.14% |
| GUS BATES INSURANCE0 Filed as: GUS NUZZOLESE | 40 KENWORTH ROAD PORT WASHINGTON, NY 11050 | AFLAC | $10 | — | $10 | 0.05% |
| BRIAN WHITE3 | 6 COWDIN LN CHAPPAQUA, NY 10514 | AFLAC | $8 | — | $8 | 0.04% |
| BENITO A ROTONDI II INC3 | 401 FRANKLIN AVE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $4 | — | $4 | 0.02% |
| LORAINE SOMMER INC3 Filed as: LORAINE SOMER | 2188 NESCONSET HWY 250 STONY BROOK, NY 11790 | AFLAC | $632 | — | $632 | 5.91% |
| RICHARD F ROTHSCHILD3 Filed as: RICHARD ROTHSCHILD | 125 2ND STREET C1 GARDEN CITY, NY 11530 | AFLAC | $556 | — | $556 | 5.20% |
| NANCY K BLOCKER3 Filed as: NANCY K MACKEY | 3631 E 48TH PL TULSA, OK 74135 | AFLAC | $173 | — | $173 | 1.62% |
| BRENTLEY HUXTABLE3 | 428 E CRYSTAL LAKE ST ORLANDO, FL 32806 | AFLAC | $171 | — | $171 | 1.60% |
| WILLIAM WHICHER3 | 1 LINDEN ST GARDEN CITY, NY 11530 | AFLAC | $131 | — | $131 | 1.23% |
| DAVID L DEARDORFF3 Filed as: DAVID DEARDORFF | 9083 E 138TH ST S BIXBY, OK 74008 | AFLAC | $64 | — | $64 | 0.60% |
| OMER S BASS IV3 | 565 W GATEWAY CT MERRITT ISLAND, FL 32952 | AFLAC | $43 | — | $43 | 0.40% |
| JOHN ROBERT DE LARIOS3 Filed as: JOHN DE LARIOS | 119 TAMAROCK CV HOLLY LAKE RANCH, TX 75765 | AFLAC | $33 | — | $33 | 0.31% |
| THE PERRY GROUP INC3 | 1650 SAND LAKE RD SUITE 201D ORLANDO, FL 32809 | AFLAC | $28 | — | $28 | 0.26% |
| RAND G SIMKINS3 Filed as: RAND SIMKINS | 1237 SHAWNEE TRL CARROLLTON, TX 75007 | AFLAC | $24 | — | $24 | 0.22% |
| KENNETH MEIER3 | 401 FRANKLIN AVE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $21 | — | $21 | 0.20% |
| MKF & ASSOCIATES INC3 | 4505 PINE TREE CIR STE 201 BIRMINGHAM, AL 35243 | AFLAC | $19 | — | $19 | 0.18% |
| LARRY D DENNY3 Filed as: LARRY DENNY | PO BOX 306 WETUMKA, OK 74883 | AFLAC | $17 | — | $17 | 0.16% |
| MICHELL ALLNER3 | 607 N DOUGLAS ST JENKS, OK 74037 | AFLAC | $14 | — | $14 | 0.13% |
| DENNY P. TWIGG3 Filed as: DENNY TWIGG | 24405 CHESTNUT ST STE 103 SANTA CLARITA, CA 91321 | AFLAC | $7 | — | $7 | 0.07% |
| PATRICK R RUHLE3 | 200 GARDEN CITY PLAZA STE 410 GARDEN CITY, NY 11530 | AFLAC | $7 | — | $7 | 0.07% |
| SANDRA VELAZQUEZ3 | 6374 SW 22ND ST MIAMI, FL 33155 | AFLAC | $7 | — | $7 | 0.07% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 10000 N 31ST AVE STE C107 PHOENIX, AZ 85051 | AFLAC | $6 | — | $6 | 0.06% |
| MARIA ORTIZ3 | 7400 SW 50 TR SUITE 300 MIAMI, FL 33155 | AFLAC | $4 | — | $4 | 0.04% |
| MARTA M SASTRE3 Filed as: MARTA SASTRE | PO BOX 140127 CORAL GABLES, FL 33114 | AFLAC | $2 | — | $2 | 0.02% |
| ALFRED RIETKERK3 | 3120 NE 47TH ST FORT LAUDERDALE, FL 33308 | AFLAC | $2 | — | $2 | 0.02% |
| OLENA K SHEA3 Filed as: OLENA SHEA | 3 MITCHELL PLACE UNIT 18C NEW YORK, NY 10017 | AFLAC | $1 | — | $1 | 0.01% |
| ADAM H MICHAELS3 | 12121 WILSHIRE BLVD STE 1225 LOS ANGELES, CA 90025 | AFLAC | $1 | — | $1 | 0.01% |
| ROBERT PERRY EVANS JR3 Filed as: ROBERT EVANS JR | 1031 SADDLEBROOK DR LUCAS, TX 75002 | AFLAC | $1 | — | $1 | 0.01% |
| PATRICIA ANNE REILLY3 Filed as: PATRICIA ALMOND | PO BOX 150804 ALTAMONTE SPRINGS, FL 32715 | AFLAC | $1 | — | $1 | 0.01% |
| MOFFATT DESIGNS LLC3 Filed as: MOFFATT DESIGNS INC | 1221 LAMPLIGHTER LANE EDMOND, OK 73034 | AFLAC | $1 | — | $1 | 0.01% |
| DAWN T SUCHECKI3 Filed as: DAWN SUCHEKI | 3850 VINE STREET SUITE 130 RIVERSIDE, CA 92507 | AFLAC | $1 | — | $1 | 0.01% |
| DOUGLAS J SUCHECKI3 Filed as: DOUGLAS SUCHECKI | 3850 VINE STREET SUITE 130 RIVERSIDE, CA 92507 | AFLAC | $1 | — | $1 | 0.01% |
| WILLIAM WHICHER3 Filed as: WILLIAM H WHICHER | 1 LINDEN ST GARDEN CITY, NY 11530 | AFLAC | $300 | — | $300 | 2.84% |
| CHRISTOPHER TARI3 | 4047 PARKSIDE DR SEAFORD, NY 11783 | AFLAC | $197 | — | $197 | 1.87% |
| RICHARD F ROTHSCHILD3 | 125 2ND ST C-1 GARDEN CITY, NY 11530 | AFLAC | $194 | — | $194 | 1.84% |
| PATRICK RUHLE3 | RUHLE RISK MANAGEMENT 200 GARDEN CITY PLAZA SUITE 410 GARDEN CITY, NY 11530 | AFLAC | $163 | — | $163 | 1.55% |
| KENNETH C MEIER CORP3 | 401 FRANKLIN AVE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $85 | — | $85 | 0.81% |
| RECRUITER MMNY INC3 | 3810 JERUSALEM AVE SEAFORD, NY 11783 | AFLAC | $63 | — | $63 | 0.60% |
| GUS BATES INSURANCE3 Filed as: GUS NUZZOLESE | 40 KENWORTH ROAD PORT WASHINGTON, NY 11050 | AFLAC | $7 | — | $7 | 0.07% |
| BRIAN WHITE3 | 6 COWDIN LN CHAPPAQUA, NY 10514 | AFLAC | $5 | — | $5 | 0.05% |
| BENITO A ROTONDI II INC3 | 401 FRANKLIN AVE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $5 | — | $5 | 0.05% |
| ROBERT S ZEMAN3 | 37 DERRYFIELD CT MANCHESTER, NH 03104 | AFLAC | $154 | — | $154 | 2.92% |
| MARGARET R WINTERS3 | 6014 GIESEKE DRIVE CRYSTAL LAKE, IL 60014 | AFLAC | $90 | — | $90 | 1.71% |
| STEVEN R KARAS3 Filed as: STEVEN KARAS | 2000 COMMONWEALTH AVE SUITE 110 AUBURNDALE, MA 02458 | AFLAC | $83 | — | $83 | 1.57% |
| KAREN TUCCI3 | 73 STETSON DR MARLBOROUGH, MA 01752 | AFLAC | $45 | — | $45 | 0.85% |
| SHANDA L FERNANDEZ3 | 4378 W 138TH ST APT 5 HAWTHRONE, CA 90250 | AFLAC | $42 | — | $42 | 0.80% |
| STEVEN R HANSON3 | 340 E 2ND STREET SUITE 310 LOS ANGELES, CA 90012 | AFLAC | $23 | — | $23 | 0.44% |
| JODY D WINTERS3 | 6014 GIESEKE DR CRYSTAL LAKE, IL 60014 | AFLAC | $22 | — | $22 | 0.42% |
| DANIEL P CLARK3 Filed as: DANIEL CLARK | 33 LANDAU ROAD PLAINVILLE, MA 02762 | AFLAC | $21 | — | $21 | 0.40% |
| DON J CONOYER3 Filed as: DON CONOYER | 303 HOGUE LN WYLIE, TX 75098 | AFLAC | $18 | — | $18 | 0.34% |
| PACIFIC FIN INST MKT3 | 92-1082 OLANI ST APT 2 KAPOLEI, HI 96707 | AFLAC | $11 | — | $11 | 0.21% |
| JR AND COOPER INC3 | 611 IRONWOOD CT APT B1 WHEELING, IL 60090 | AFLAC | $11 | — | $11 | 0.21% |
| CHAD L NELSON3 Filed as: CHAD NELSON | 490 EAST ROOSEVELT ROAD STE 203 WEST CHICAGO, IL 60185 | AFLAC | $5 | — | $5 | 0.09% |
| MAUREEN E SNOW3 Filed as: MAUREEN SNOW | 68 WINGATE RD HOLLISTON, MA 01746 | AFLAC | $3 | — | $3 | 0.06% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C MEIER | 401 FRANKLIN AVENUE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $3 | — | $3 | 0.06% |
| TODD V MASON3 | 6164 LAWRENCE ST CYPRESS, CA 90630 | AFLAC | $1 | — | $1 | 0.02% |
| RICHARD F ROTHSCHILD3 Filed as: RICHARD ROTHSCHILD | 125 2ND STREET C1 GARDEN CITY, NY 11530 | AFLAC | $1 | — | $1 | 0.02% |
| JILL SCIRPO3 | 6 WILLETT POND RD WESTWOOD, MA 02090 | AFLAC | $1 | — | $1 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 NONE | Participant communication; Float revenue; Named fiduciary; Contract Administrator; Non-monetary compensation; Claims processing; Other services; Direct payment from the plan Service code 12 | — | $689K |
| BENEFITS MANAGEMENT SOLUTIONS EIN 11-3516037 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $73K |
| DELTA DENTAL OF NY EIN 11-1980218 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $69K |
| RESPONSEWORKS, INC. EIN 22-3563649 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $35K |
| WAGNER & ZWERMAN LLP EIN 11-2836481 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $15K |
| CIGNA | Contract Administrator; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $964 |
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 | 1,195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 82 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 71 | $762K |
| Vision | VISION SERVICE PLAN | 1,037 | $164K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 0 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,037 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.