| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUBICON BENEFITS LLC3 Filed as: RUBICON BENEFITS, LLC | 718 WALT WHITMAN ROAD, UNIT 1568 MELVILLE, NY 11747 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $77K | $0 | $77K | 3.52% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN. SVCS | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $0 | $25K | $25K | 1.15% |
| 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 | 6.45% |
| 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 | 1.07% |
| 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 | $18K | $4K | $22K | 23.70% |
| RUBICON BENEFITS LLC3 Filed as: RUBICON BENEFITS, LLC | 718 WALT WHITMAN ROAD, UNIT 1568 MELVILLE, NY 11747 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $10K | $0 | $10K | 20.42% |
| EPSIX, INC.3 | 3300 NORTH SCOTTSDALE ROAD APARTMENT 4020 SCOTTSDALE, AZ 85251 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $10K | $0 | $10K | 19.36% |
| CHARLEEN A WRIGHT3 Filed as: CHARLEEN ANTOINETTE WRIGHT | 2565 ALLEGHANY LOOP VIRGINIA BEACH, VA 23456 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 11.55% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $356 | $0 | $356 | 0.70% |
| MJ INSURANCE3 Filed as: THOMAS MCKIERNAN AND VARIOUS AGENTS | 3015 NORTH SCOTTSDALE ROAD UNIT 1210 SCOTTSDALE, AZ 85251 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $163 | $0 | $163 | 0.32% |
| DANA E ERO3 Filed as: DANA E. ERO | 227 VERBECK AVENUE SCHAGHTICOKE, NY 12154 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $120 | $0 | $120 | 0.23% |
| ROBERT THOMAS JENSEN3 | 14107 20TH AVENUE WHITESTONE, NY 11357 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $102 | $0 | $102 | 0.20% |
| 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 | 3.88% |
| CHARLEEN A WRIGHT3 Filed as: CHARLEEN ANTOINETTE WRIGHT | 2565 ALLEGHANY LOOP VIRGINIA BEACH, VA 23456 | AFLAC | $512 | $58 | $570 | 4.08% |
| MJ INSURANCE3 Filed as: EPSIX, INC. AND VARIOUS AGENTS | 687 EAST BROADWAY MILFORD, CT 06460 | AFLAC | $395 | $1 | $396 | 2.83% |
| JOEL B KARAS3 Filed as: JOEL B. KARAS | 130 PARSONS STREET BRIGHTON, MA 02135 | AFLAC | $391 | $0 | $391 | 2.80% |
| STEVEN R KARAS3 Filed as: STEVEN R. KARAS | 222 WARD STREET NEWTON, MA 02459 | AFLAC | $212 | $0 | $212 | 1.52% |
| RUBICON BENEFITS LLC3 Filed as: RUBICON BENEFITS, LLC | 718 WALT WHITMAN ROAD, UNIT 1568 MELVILLE, NY 11747 | AFLAC | $176 | $0 | $176 | 1.26% |
| GLENN E SMITH3 Filed as: GLENN E. SMITH | 1136 MASTERS ROW CHESAPEAKE, VA 23320 | AFLAC | $107 | $13 | $120 | 0.86% |
| DAVID J MCCLELLAN3 Filed as: DAVID HALLETT | 8 BROOKS STREET WINCHESTER, MA 01890 | AFLAC | $96 | $0 | $96 | 0.69% |
| MJ INSURANCE3 Filed as: EPSIX, INC. AND VARIOUS AGENTS | 687 EAST BROADWAY MILFORD, CT 06460 | AFLAC | $388 | $4 | $392 | 3.05% |
| CHARLEEN A WRIGHT3 Filed as: CHARLEEN ANTOINETTE WRIGHT | 2565 ALLEGHANY LOOP VIRGINIA BEACH, VA 23456 | AFLAC | $299 | $16 | $315 | 2.45% |
| DANA E ERO3 Filed as: DANA E. ERO | 5 PINE WEST PLAZA, SUITE 503 ALBANY, NY 12205 | AFLAC | $132 | $0 | $132 | 1.03% |
| GLENN E SMITH3 Filed as: GLENN E. SMITH | 1136 MASTERS ROW CHESAPEAKE, VA 23320 | AFLAC | $97 | $4 | $101 | 0.78% |
| LOUIS J DEGATI3 Filed as: LOUIS J. DEGATI | 16059 23RD AVENUE WHITESTONE, NY 11357 | AFLAC | $87 | $0 | $87 | 0.68% |
| PHILLIP GREER3 | 2881 BALD EAGLE ROAD VIRGINIA BEACH, VA 23453 | AFLAC | $68 | $0 | $68 | 0.53% |
| JOHANN S SCRIMSHIRE3 Filed as: JOHANN SCHRIMSHIRE | 200 SOUTH MAIN STREET SUITE 130-405 SEBASTOPOL, CA 95472 | AFLAC | $67 | $0 | $67 | 0.52% |
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 | 196 | 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) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 176 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 145 | $94K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 145 | $94K |
| Life insurance(3 contracts, 3 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 196 | $198K |
| Short-term disability(3 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 196 | $144K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 196 | $117K |
| Prescription drug | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 176 | $2.2M |
| Other(3 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 196 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.
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.