| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUBICON BENEFITS LLC3 Filed as: RUBICON BENEFITS, LLC | 718 WALT WHITMAN ROAD, SUITE 1568 MELVILLE, NY 11747 | EMPRE HEALTHCHOICE ASSURANCE, INC. | $80K | $0 | $80K | 3.70% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN. SVCS | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | EMPRE HEALTHCHOICE ASSURANCE, INC. | $0 | $26K | $26K | 1.22% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 01982 | EMPRE HEALTHCHOICE ASSURANCE, INC. | $286 | $0 | $286 | 0.01% |
| RUBICON BENEFITS LLC3 Filed as: RUBICON BENEFITS, LLC | 718 WALT WHITMAN ROAD, UNIT 1568 MELVILLE, NY 11747 | MUTUAL OF OMAHA INSURANCE COMPANY | $8K | $0 | $8K | 6.34% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN. SVCS | 1133 WESTCHESTER AVENUE SUITE S229 WHITE PLAINS, NY 10604 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $1K | $1K | 1.03% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN. SVCS | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $20K | $2K | $22K | 20.54% |
| EPSIX, INC.3 | 3300 NORTH SCOTTSDALE ROAD APARTMENT 4020 SCOTTSDALE, AZ 85251 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $11K | $0 | $11K | 25.20% |
| RUBICON BENEFITS LLC3 Filed as: RUBICON BENEFITS, LLC | 718 WALT WHITMAN ROAD, SUITE 1568 MELVILLE, NY 11747 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $9K | $0 | $9K | 20.21% |
| CHARLEEN A WRIGHT3 Filed as: CHARLEEN ANTOINETTE WRIGHT | 2565 ALLEGHANY LOOP VIRGINIA BEACH, VA 23456 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.42% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 8.78% |
| MJ INSURANCE3 Filed as: THOMAS MCKIERNAN AND VARIOUS AGENTS | 3015 NORTH SCOTTSDALE ROAD UNIT 1210 SCOTTSDALE, AZ 85251 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $2K | $295 | $2K | 5.21% |
| DANA E ERO3 Filed as: DANA E. ERO | 227 VERBECK AVENUE SCHAGHTICOKE, NY 12154 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 3.11% |
| ROBERT THOMAS JENSEN3 | 14107 20TH AVENUE WHITESTONE, NY 11357 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.75% |
| RUBICON BENEFITS LLC3 Filed as: RUBICON BENEFITS, LLC | 718 WALT WHITMAN ROAD, UNIT 1568 MELVILLE, NY 11747 | COMPANION LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN. SVCS | 1133 WESTCHESTER AVENUE SUITE S229 WHITE PLAINS, NY 10604 | COMPANION LIFE INSURANCE COMPANY | $0 | $1K | $1K | 4.14% |
| CHARLEEN WRIGHT3 | 2565 ALLEGHANY LOOP VIRGINIA BEACH, VA 23456 | AFLAC | $2K | $18 | $2K | 56.84% |
| MJ INSURANCE3 Filed as: LOUIS DEGATI AND VARIOUS AGENTS | 16059 23RD AVENUE WHITESTONE, NY 11357 | AFLAC | $359 | $181 | $540 | 20.13% |
| THE ESTATE OF DANA E ERO3 Filed as: THE ESTATE OF DANA E. ERO | 174 MAIN STREET SCHAGHTICOKE, NY 12154 | AFLAC | $184 | $108 | $292 | 10.88% |
| PHILLIP GREER3 | 2881 BALD EAGLE ROAD VIRGINIA BEACH, VA 23453 | AFLAC | $214 | $4 | $218 | 8.13% |
| GLENN E SMITH3 Filed as: GLENN SMITH | 1136 MASTERS ROW CHESAPEAKE, VA 23320 | AFLAC | $203 | $4 | $207 | 7.72% |
| JOEL B KARAS3 Filed as: JOEL KARAS | 7 CUFFLIN STREET BRIGHTON, MA 02135 | AFLAC | $108 | $79 | $187 | 6.97% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE, INC. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02110 | AFLAC | $108 | $0 | $108 | 4.03% |
| MJ INSURANCE3 Filed as: DAVID HALLETT AND VARIOUS AGENTS | 8 BROOKS STREET WINCHESTER, MA 01890 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $577 | $145 | $722 | 38.49% |
| CHARLEEN WRIGHT3 | 2565 ALLEGHANY LOOP VIRGINIA BEACH, VA 23456 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $467 | $18 | $485 | 25.85% |
| JOEL B KARAS3 Filed as: JOEL KARAS | 7 CUFFLIN STREET BRIGHTON, MA 02135 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $168 | $301 | $469 | 25.00% |
| STEVEN R KARAS3 Filed as: STEVEN KARAS | 222 WARD STREET NEWTON, MA 02456 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $236 | $70 | $306 | 16.31% |
| THE ESTATE OF DANA E ERO3 Filed as: THE ESTATE OF DANA E. ERO | 174 MAIN STREET SCHAGHTICOKE, NY 12154 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $131 | $90 | $221 | 11.78% |
| ROBERT THOMAS JENSEN3 Filed as: ROBERT JENSEN | 2 SOUTHDOWN COURT HUNTINGTON, NY 11743 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $137 | $24 | $161 | 8.58% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE, INC. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02110 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $160 | $0 | $160 | 8.53% |
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 | 205 | 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) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPRE HEALTHCHOICE ASSURANCE, INC. | 170 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 147 | $106K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 147 | $106K |
| Life insurance(3 contracts, 3 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 205 | $194K |
| Short-term disability(3 contracts, 3 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 205 | $124K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 205 | $120K |
| Prescription drug | EMPRE HEALTHCHOICE ASSURANCE, INC. | 170 | $2.2M |
| Other(3 contracts, 3 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 205 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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.
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.