| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 400 MIDLAND DRIVE MT LAUREL, NJ 08085 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 1.64% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 10 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $485 | $485 | 0.07% |
| ADVANCED VOLUNTARY CONCEPTS INC3 | 75 SOUTH BROADWAY WHITE PLAINS, NY 10601 | THE PAUL REVERE LIFE INSURANCE COMPANY | $20K | — | $20K | 8.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE PAUL REVERE LIFE INSURANCE COMPANY | $13K | — | $13K | 5.12% |
| SALATHIEL MALDONADO3 | 3717 CYPRESS AVE BROOKLYN, NY 11224 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | — | $2K | 0.83% |
| WILLIAM CHARLES HEYDT3 | 243 LONGSDALE DR MERZTOWN, PA 19539 | THE PAUL REVERE LIFE INSURANCE COMPANY | $220 | $54 | $274 | 0.11% |
| DAVID MICHAEL LAMORTE3 | PO BOX 3803 DANBURY, CT 06813 | THE PAUL REVERE LIFE INSURANCE COMPANY | $229 | — | $229 | 0.09% |
| KIMANI MATTHEW3 | 153 SOUTH 11TH AVE MT VERNON, NY 10550 | THE PAUL REVERE LIFE INSURANCE COMPANY | $203 | $5 | $208 | 0.08% |
| ADVANCED VOLUNTARY CONCEPTS INC3 | 75 SOUTH BROADWAY WHITE PLAINS, NY 10601 | THE PAUL REVERE LIFE INSURANCE COMPANY | $10K | — | $10K | 11.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5K | — | $5K | 5.32% |
| KIMANI MATTHEW3 | 153 SOUTH 11TH AVE MT VERNON, NY 10550 | THE PAUL REVERE LIFE INSURANCE COMPANY | $347 | $28 | $375 | 0.43% |
| WILLIAM CHARLES HEYDT3 | 243 LONGSDALE DR MERZTOWN, PA 19539 | THE PAUL REVERE LIFE INSURANCE COMPANY | $79 | $20 | $99 | 0.11% |
| DAVID MICHAEL LAMORTE3 | PO BOX 3803 DANBURY, CT 06813 | THE PAUL REVERE LIFE INSURANCE COMPANY | $82 | — | $82 | 0.09% |
| INTEGRATED BENEFITS RESOURCES3 | 333 SYLVOM AVE STE 218 ENGLEWOOD CLIFFS, NJ 07632 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $306 | — | $306 | 4.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2081 VISTA PARKWAY STE 300 WEST PALM BEACH, FL 33411 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $102 | — | $102 | 1.34% |
| LONERGAN, DOUGLAS, DOOLAN3 Filed as: LONERGAN, DOUGLAS | 61644 TAM MCARTHUR LOOP BEND, OR 97702 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $102 | — | $102 | 1.34% |
| CLARK, DOUGLAS W3 | 270 FARMINGTON AVE STE 306 FARMINGTON, CT 060321909 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $203 | — | $203 | 2.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD STE 1000 ROLLING MDWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $111 | — | $111 | 3.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC | 200 LIBERTY ST NEW YORK, NY 10128 | FIRST UNUM LIFE INSURANCE COMPANY | $27 | — | $27 | 0.81% |
| MICHAEL T KUCZINSKI3 | C/O MTK FINANCIAL GROUP MILLSTONE TOWNSHIP, NJ 08535 | FIRST UNUM LIFE INSURANCE COMPANY | $15 | — | $15 | 0.45% |
| MARK VOLPE3 | 50 SYLVIA TER MIDDLETOWN, NJ 07748 | FIRST UNUM LIFE INSURANCE COMPANY | $11 | — | $11 | 0.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPSYCH EIN 35-3739783 THIRD PARTY | Contract Administrator Service code 13 | — | $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 | 1,545 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,545 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,545 | $719K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,545 | $792K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,545 | $705K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,545 | $953K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,545 | — |
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.