| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LONG ISLAND EMPLOYEE BENEFITS GROUP3 | 325 WIRELESS BLVD. HAUPPAUGE, NY 11788 | EMBLEM HEALTH | $411K | — | $411K | 4.08% |
| LONG ISLAND EMPLOYEE BENEFITS GROUP3 | 325 WIRELESS BLVD. HAUPPAUGE, NY 11788 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $10K | — | $10K | 6.59% |
| ADVANCED VOLUNTARY CONCEPTS INC3 Filed as: ADVANCED VOLUNTARY CONCEPTS, INC. | 75 SOUTH BROADWAY, SUITE 415 WHITE PLAINS, NY 10601 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $9K | — | $9K | 6.11% |
| LONG ISLAND EMPLOYEE BENEFITS GROUP3 | 325 WIRELESS BLVD. HAUPPAUGE, NY 11788 | SHELTER POINT LIFE INSURANCE COMPANY | $6K | — | $6K | 4.47% |
| LONG ISLAND EMPLOYEE BENEFITS GROUP3 | 325 WIRELESS BLVD. HAUPPAUGE, NY 11788 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $11K | — | $11K | 10.00% |
| THE DBL CENTER LTD3 Filed as: THE DBL CENTER, LTD. | 555 BROADHOLLOW ROAD, SUITE 271 MELVILLE, NY 11747 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $2K | $2K | 1.78% |
| LONG ISLAND EMPLOYEE BENEFITS GROUP3 | 325 WIRELESS BLVD. HAUPPAUGE, NY 11788 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 4.32% |
| VINCENT TAYLOR ECHOLS3 Filed as: VINCENT JOSEPH KRILL | 1 BLUE HILL PLAZA SUITE 1535 PEARL RIVER, NY 10965 | AFLAC | $13K | $294 | $13K | 22.67% |
| TAYLOR J COOMBS3 Filed as: TAYLOR J. COOMBS | 1 CRONOMER HEIGHTS DRIVE NEWBURGH, NY 12550 | AFLAC | $10K | — | $10K | 17.78% |
| JASON SCZEPANIAK3 Filed as: JASON HARTMAN | 225 DOLSON AVENUE SUITE 304 MIDDLETOWN, NY 10940 | AFLAC | $3K | — | $3K | 4.63% |
| JARED KANSKY3 | 86 JOAN DRIVE NEW CITY, NY 10956 | AFLAC | $648 | — | $648 | 1.12% |
| MICHELE J ZRELAK3 Filed as: MICHELE J. ZRELAK | 8 MULLER DRIVE NEW CITY, NY 10958 | AFLAC | $632 | — | $632 | 1.09% |
| JESSICA KRILL3 Filed as: JESSICA C. KRILL | 12 WEST STREET APT 6 GOSHEN, NY 10924 | AFLAC | $274 | — | $274 | 0.47% |
| JESSE PELIGRI3 | 138 FOLTIM WAY CONGERS, NY 10920 | AFLAC | $118 | — | $118 | 0.20% |
| ELIZABETH L. PETERSON3 | 557 AVALON GARDENS DRIVE NANUET, NY 10954 | AFLAC | $62 | — | $62 | 0.11% |
| RYAN HAFF3 | 496 LT BRENDER HIGHWAY FERNDALE, NY 12734 | AFLAC | $48 | — | $48 | 0.08% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | AFLAC | $45 | — | $45 | 0.08% |
| RANDI E RIVA3 Filed as: RANDI E. RIVA | 312 GALLERY LANE MOUNT BETHEL, PA 18343 | AFLAC | $5 | — | $5 | 0.01% |
| JEFF DALABA3 | 8500 GILLY FLOWER COURT BALDWINSVILLE, NY 13027 | AFLAC | $5 | — | $5 | 0.01% |
| JENNIFER LIPINS3 | 78 HUNT AVENUE APT. 3A PEARL RIVER, NY 10965 | AFLAC | $3 | — | $3 | 0.01% |
| ADVANCED VOLUNTARY CONCEPTS INC3 Filed as: ADVANCED VOLUNTARY CONCEPTS, INC | 75 SOUTH BROADWAY, SUITE 415 WHITE PLAINS, NY 10601 | LIFE INSURANCE COMPANY OF BOSTON AND NEW YORK | $2K | — | $2K | 4.48% |
| LONG ISLAND EMPLOYEE BENEFITS GROUP3 | 325 WIRELESS BLVD. HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF BOSTON AND NEW YORK | $976 | — | $976 | 1.99% |
| LONG ISLAND EMPLOYEE BENEFITS GROUP3 | 325 WIRELESS BLVD. HAUPPAUGE, NY 11788 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 13.89% |
| LONG ISLAND EMPLOYEE BENEFITS GROUP3 | 325 WIRELESS BLVD. HAUPPAUGE, NY 11788 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 20.00% |
| LONG ISLAND EMPLOYEE BENEFITS GROUP3 | 325 WIRELESS BLVD. HAUPPAUGE, NY 11788 | DAVIS VISION | $5K | — | $5K | — |
| LONG ISLAND EMPLOYEE BENEFITS GROUP3 | 325 WIRELESS BLVD. HAUPPAUGE, NY 11788 | DELTA DENTAL OF NEW YORK, INC. | $27K | — | $27K | — |
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 | 1,426 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,426 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMBLEM HEALTH | 815 | $10.1M |
| Dental | DELTA DENTAL OF NEW YORK, INC. | 2,139 | $0 |
| Vision | DAVIS VISION | 1,031 | $0 |
| Life insurance(2 contracts, 2 carriers) | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,216 | $126K |
| Short-term disability(3 contracts, 3 carriers) | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | 1,426 | $347K |
| Long-term disability(2 contracts, 2 carriers) | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,216 | $127K |
| Prescription drug | EMBLEM HEALTH | 815 | $10.1M |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 10 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,139 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.