| 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 | $715 | $3K | $4K | 1.86% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 10877 WHITE ROCK RD RANCHO CORDOVA, CA 95670 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | — | $2K | 8.65% |
| PATRICK MICHAEL KIERNAN3 | 28 SEAFIELD LN BAY SHORE, NY 11706 | THE PAUL REVERE LIFE INSURANCE COMPANY | $514 | — | $514 | 2.93% |
| VANESSA N DEAN3 | 1052 ASHFORD AVE APT 802 SAN JUAN, PR 00907 | THE PAUL REVERE LIFE INSURANCE COMPANY | $204 | — | $204 | 1.16% |
| WALTER THOMAS BONILLA3 | 9 LONGLEAF LN MEDFORD, NY 11763 | THE PAUL REVERE LIFE INSURANCE COMPANY | $110 | $63 | $173 | 0.99% |
| LAUREN JACOBS3 | 364 RED MAPLE DR W WANTAGH, NY 11793 | THE PAUL REVERE LIFE INSURANCE COMPANY | $156 | — | $156 | 0.89% |
| NORMA STEELE3 | 1225 FRANKLIN AVE STE 250 GARDEN CITY, NY 11530 | THE PAUL REVERE LIFE INSURANCE COMPANY | $98 | — | $98 | 0.56% |
| FLEURY ENTERPRISES INC3 | 162 INDIAN POINT RD TIVERTON, RI 02878 | THE PAUL REVERE LIFE INSURANCE COMPANY | $56 | — | $56 | 0.32% |
| EILEEN SANCHEZ MEDINA3 Filed as: EILEEN E BERG | 319 THOMASTON RD UNIT 12 WATERTOWN, CT 06795 | THE PAUL REVERE LIFE INSURANCE COMPANY | $44 | — | $44 | 0.25% |
| ROSEANN REYNOLDS3 | 163 CEDAR ST UNIT 2B BRANFORD, CT 06405 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7 | — | $7 | 0.04% |
| PENELOPE ELLEN DEAN3 | 1052 ASHFORD AVE APT 802 SAN JUAN, PR 00907 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | — | $1 | 0.01% |
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 | 170 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS | 111 | $1.4M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 170 | $204K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 170 | $204K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 170 | $204K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 170 | $204K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 170 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.