| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE NEW YORK, NY 10016 | AETNA LIFE INSURANCE COMPANY | $81K | $8K | $89K | 2.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC AVENUE MOUNT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $10K | $4K | $14K | 0.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AETNA LIFE INSURANCE COMPANY | $2K | $412 | $3K | 0.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | FIRST UNUM LIFE INSURANCE COMPANY | $16K | $3K | $19K | 5.71% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCESERVICES LLC | PO BOX 62939 VIRGINIA BEACH, VA 23466 | FIRST UNUM LIFE INSURANCE COMPANY | $6K | $6K | $12K | 3.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE, 3RD FLOOR NEW YORK, NY 10177 | STANDARD OF NEW YORK | $17K | $4K | $20K | 12.11% |
| KRISTEN PARZIANO3 | 15 10TH STREET STATEN ISLAND, NY 10306 | AFLAC | $4K | $97 | $4K | 5.21% |
| MJ INSURANCE3 Filed as: PATRICK HARDIE AND VARIOUS AGENTS | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $2K | $0 | $2K | 2.51% |
| ANTHONY LIBECCI3 | 4864 ARTHUR KILL ROAD, SUITE 3 STATEN ISLAND, NY 10309 | AFLAC | $2K | $20 | $2K | 2.40% |
| MICHAEL S TEITELBAUM3 Filed as: MICHAEL TEITELBAUM | 4023 WEST SAN PEDRO STREET TAMPA, FL 33629 | AFLAC | $1K | $2 | $1K | 2.02% |
| YANIRA TEITELBAUM3 | 76 WATERMAN AVENUE RUMSON, NJ 07760 | AFLAC | $753 | $0 | $753 | 1.05% |
| ANGELA MONTENEGRO3 | 74 HILLANDALE DRIVE NEW ROCHELLE, NY 10804 | AFLAC | $401 | $20 | $421 | 0.59% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY R. ORGERA, INC. | 35 PINELAWN ROAD, SUITE 190 MELVILLE, NY 11747 | AFLAC | $411 | $0 | $411 | 0.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO NY | $628 | $0 | $628 | 3.68% |
| KRISTEN PARZIANO3 | 15 10TH STREET STATEN ISLAND, NY 10306 | AFLAC | $1K | $191 | $2K | 11.35% |
| ANTHONY LIBECCI3 | 4864 ARTHUR KILL ROAD, SUITE 3 STATEN ISLAND, NY 10309 | AFLAC | $524 | $32 | $556 | 3.85% |
| ANGELA MONTENEGRO3 | 74 HILLANDALE DRIVE NEW ROCHELLE, NY 10804 | AFLAC | $223 | $32 | $255 | 1.77% |
| BEAULIEU BENEFITS INC3 Filed as: BEAULIEU BENEFITS AND OTHER AGENTS | 577 MARITIME WAY SUPPLY, NC 28462 | AFLAC | $152 | $0 | $152 | 1.05% |
| PATRICK RUHLE3 Filed as: PATRICK HARDIE | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $67 | $0 | $67 | 0.46% |
| MICHAEL S TEITELBAUM3 Filed as: MICHAEL TEITELBAUM | 4023 WEST SAN PEDRO STREET TAMPA, FL 33629 | AFLAC | $54 | $0 | $54 | 0.37% |
| YANIRA TEITELBAUM3 | 76 WATERMAN AVENUE RUMSON, NJ 07760 | AFLAC | $41 | $0 | $41 | 0.28% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NORTHEAST, INC. | 165 BROADWAY, 33RD FLOOR NEW YORK, NY 10006 | FEDERAL INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
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 | 215 | 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) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 309 | $3.7M |
| Dental | AETNA LIFE INSURANCE COMPANY | 309 | $3.7M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO NY | 224 | $17K |
| Life insurance | STANDARD OF NEW YORK | 215 | $169K |
| Short-term disability(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 151 | $346K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 151 | $339K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 309 | $3.7M |
| Other(6 contracts, 5 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 215 | $611K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 309 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.