| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE HOTALING GROUP3 Filed as: HOTALING GROUP | 8 FLETCHER PLACE MELVILLE, NY 11747 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $7K | — | $7K | 6.94% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SVCS LLC | 2 ENTERPRISE DRIVE, SUITE 204 SHELTON, CT 06484 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $4K | $4K | 3.97% |
| THE HOTALING GROUP3 | 8 FLETCHER PLACE MELVILLE, NY 11747 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $8K | $0 | $8K | 9.89% |
| ACRISURE LLC3 | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $2K | $2K | $4K | 4.61% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DRIVE, CENTER II SUITE 305 ELMWOOD PARK, NJ 07407 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $0 | $2K | $2K | 2.49% |
| SAL RESTIVO INSURANCE BROKERAGE COR3 Filed as: SAL RESTIVO INS. BROKERAGE CORP. | 248 ROUTE 25A, SUITE 3009 EAST SETAUKET, NY 11733 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $7K | $0 | $7K | 16.59% |
| JOSHUA PAUL GROUP INC3 Filed as: JOSHUA SAUNDERS | 17 OAK LANE RANDOLPH, NJ 07869 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $681 | $19 | $700 | 1.71% |
| ANTHONY CAVALLARO3 | 1 BAY CLUB DRIVE, APARTMENT 4A BAYSIDE, NY 11360 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $513 | $19 | $532 | 1.30% |
| JACQUES P DAVID CORPORATION3 Filed as: JACQUES P. DAVID CORPORATION | 5 MONFORT DRIVE HUNTINGTON, NY 11743 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $369 | $0 | $369 | 0.90% |
| MARGARET BRESLIN3 Filed as: MARGARET BRESLIN AND OTHER AGENTS | 336 ALFRED STREET NORTH BABYLON, NY 11703 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $311 | $0 | $311 | 0.76% |
| MICHAEL BURACK3 | 46 THREEPENCE DRIVE MELLVILLE, NY 11747 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $219 | $0 | $219 | 0.53% |
| SALVATORE A RESTIVO3 Filed as: SALVATORE RESTIVO | 248 ROUTE 25A, SUITE 3009 EAST SETAUKET, NY 11733 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK | $125 | $0 | $125 | 0.31% |
| THE HOTALING GROUP3 | 8 FLETCHER PIACE MELLVILLE, NY 11747 | VISION SERVICE PLAN | $917 | — | $917 | 5.73% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | VISION SERVICE PLAN | $881 | — | $881 | 5.50% |
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 | 240 | 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) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 93 | $98K |
| Vision | VISION SERVICE PLAN | 96 | $16K |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 240 | $76K |
| Short-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 240 | $76K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 240 | $76K |
| Other(2 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 240 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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.