| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PETER VON HALLE3 | 48 NOTCH ROAD LITTLE FALLS, NJ 07424 | EMBLEMHEALTH | $66K | — | $66K | 5.24% |
| PETER VON HALLE3 Filed as: PETER E VONHALLE | 48 CLINTON AVE RIDGEWOOD, NJ 07450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 7.00% |
| CFS MONTCLAIR LLC3 | 103 EISENHOWER PARKWAY ROSELAND, NJ 07068 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $139 | — | $139 | 0.24% |
| ANDREW J SCHLOSSMAN3 | 16625 POWELLS COVE BLVD APT 10A WHITESTONE, NY 11357 | AFLAC | $248 | — | $248 | 6.19% |
| J G DENIVO CORP3 | 14 107 20TH AVE SUITE 102 WHITESTONE, NY 11357 | AFLAC | $180 | — | $180 | 4.49% |
| STEPHEN P WHITE3 | 5 EMERALD LANE MONTEBELLO, NY 10901 | AFLAC | $49 | — | $49 | 1.22% |
| DALE CAMERON THOMAS3 | 28 OLD FULTON STREET APT 6H BROOKLYN, NY 11201 | AFLAC | $43 | — | $43 | 1.07% |
| JENNIFER E LUBELSKY3 Filed as: JENNIFER ELIA LUBELSKY | 80 JOHN ST 11C NEW YORK, NY 10038 | AFLAC | $36 | — | $36 | 0.90% |
| KOBER ASSOCIATES LLC3 | 14107 20TH AVE SUITE 507 WHITESTONE, NY 11357 | AFLAC | $35 | — | $35 | 0.87% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY R ORGERA INC. | 14 WALL ST SUITE 8C ATTN AFLAC NEW YORK, NY 10005 | AFLAC | $25 | — | $25 | 0.62% |
| KENNETH C MEIER CORP3 | 401 FRANKLIN AVENUE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $25 | — | $25 | 0.62% |
| PATRICK RUHLE3 Filed as: PATRICK C HARDIE | 14 WALL STREET SUITE 8C NEW YORK, NY 10005 | AFLAC | $14 | — | $14 | 0.35% |
| SHELDON F SCHIFF3 | MILLER POMERANTZ FINANCIAL AND INS 120 BROADWAY 29FL NEW YORK, NY 10271 | AFLAC | $4 | — | $4 | 0.10% |
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 | 123 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMBLEMHEALTH | 140 | $1.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 109 | $59K |
| Life insurance | AFLAC | 4 | $4K |
| Short-term disability | AFLAC | 4 | $4K |
| Prescription drug | EMBLEMHEALTH | 140 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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 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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.