| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 40 MARCUS DRIVE 3RD FLOOR MELVILLE, NY 11747 | THE GUARDIAN LIFE INSURANCE COMPANY | $1K | $1K | $3K | 0.97% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 461 PATIAGO ROAD EAST HAMPTON, NY 11937 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3K | — | $3K | 7.11% |
| LAUREN JACOBS3 | 364 RED MAPLE DRIVE W WANTAGH, NY 11793 | THE PAUL REVERE LIFE INSURANCE COMPANY | $475 | $7 | $482 | 1.14% |
| PATRICK MICHAEL KIERNAN3 | 28 SEAFIELD LANE BAY SHORE, NY 11706 | THE PAUL REVERE LIFE INSURANCE COMPANY | $401 | — | $401 | 0.95% |
| VENESSA N DEAN3 | 1052 ASHFORD AVENUE APT 802 SAN JUAN, PR 00907 | THE PAUL REVERE LIFE INSURANCE COMPANY | $336 | — | $336 | 0.80% |
| NORMA STEELE3 | 1225 FRANKLIN AVENUE SUITE 250 GARDEN CITY, NY 11530 | THE PAUL REVERE LIFE INSURANCE COMPANY | $240 | $40 | $280 | 0.66% |
| WALTER THOMAS BONILLA3 | 9 LONGLEAF LANE MEDFORD, NY 11763 | THE PAUL REVERE LIFE INSURANCE COMPANY | $205 | $16 | $221 | 0.52% |
| FLEURY ENTERPRISES INC3 Filed as: FLEURY ENTERPRISES INC. | 162 INDIAN POINT ROAD TIVERTON, RI 02878 | THE PAUL REVERE LIFE INSURANCE COMPANY | $104 | — | $104 | 0.25% |
| EILEEN SANCHEZ MEDINA3 Filed as: EILEEN E BERG | 319 THOMASTON ROAD WATERTOWN, CT 06795 | THE PAUL REVERE LIFE INSURANCE COMPANY | $88 | — | $88 | 0.21% |
| DENISE LOFFREDO3 | 52 W CHERBOURG DRIVE CHEEKTOWAGA, NY 14227 | THE PAUL REVERE LIFE INSURANCE COMPANY | $55 | — | $55 | 0.13% |
| ROSEANN REYNOLDS3 | 163 CEDAR STREET BRANFORD, CT 06405 | THE PAUL REVERE LIFE INSURANCE COMPANY | $14 | — | $14 | 0.03% |
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. |
| Total participants (= "Plan participants" tile) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 185 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 205 | $266K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 205 | $266K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 205 | $266K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 205 | $266K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 205 | $308K |
| 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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.