| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SAMMON EMPLOYEE BENEFITS LLC3 | 11 FULTON AVE RYE, NY 10580 | UNITEDHEALTHCARE INSURANCE COMPANY | $65K | — | $65K | 4.00% |
| ACRISURE LLC3 Filed as: ACRISURE PGM INSURANCE SERVICES, | LLC-GA 311 CLOCK TOWER CMNS BREWSTER, NY 105094059 | UNITEDHEALTHCARE INSURANCE COMPANY | $1 | $15K | $15K | 0.94% |
| ROBERT SAMMON3 Filed as: ROBERT J SAMMON | 11 FULTON AVE RYE, NY 10580 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | — | $4K | 11.94% |
| PROFESSIONAL GROUP MARKETING INC3 Filed as: PROFESSIONAL GROUP MARKETING I | 50 BROADWAY HAWTHORNE, NY 10532 | FIRST UNUM LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| ROBERT SAMMON3 | 11 FULTON AVE RYE, NY 105802515 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 6.39% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 503232317 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 3.18% |
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 | 103 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 172 | $1.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 73 | $31K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 98 | $32K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 98 | $32K |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 98 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.