| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BETH SERFILIPPI | 8 HILLSTONE CT BALLSTON LAKE, NY 12019 | AFLAC | $1K | — | $1K | 2.58% |
| SUSAN M TODD-BEDELL | 249 N BALLSTON AVE SCOTIA, NY 12302 | AFLAC | $965 | $45 | $1K | 2.12% |
| MARY R COLEMAN Filed as: MARY COLEMAN | 44 RIDGE RD RENSSELAER, NY 12144 | AFLAC | $441 | $212 | $653 | 1.37% |
| DARRYL J YOUNG | 3820 GOLD CITY RD FRANKLIN, KY 42134 | AFLAC | $506 | — | $506 | 1.06% |
| MCINERNEY GROUP LLC | 580 WHITE PLAINS RD STE 115 TARRYTOWN, NY 10591 | AFLAC | $461 | $18 | $479 | 1.00% |
| JANINE FOX Filed as: JANINE M FOX | 18 HAVILAND DR SCHENECTADY, NY 12302 | AFLAC | $369 | $48 | $417 | 0.87% |
| DEBORAH M TALLMAN | 316A GULF RD COHOES, NY 12047 | AFLAC | $212 | — | $212 | 0.44% |
| ACRISURE LLC3 Filed as: HAYLOR FREYER & COON INC | 231 SALINA MEADOWS PKWY SYRACUSE, NY 13212 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 5.46% |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: BROWN & BROWN OF NEW YORK INC. | 110 LANGLEY ROAD ROME, NY 13441 | THE PAUL REVERE LIFE INSURANCE COMPANY | $176 | — | $176 | 4.00% |
| DONALD H MATSON Filed as: DONALD JH MATSON | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $176 | — | $176 | 4.00% |
| ASHLEY GRANATO | 4 EMMA ST AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $39 | — | $39 | 0.89% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | HM LIFE INSURANCE COMPANY OF NEW YORK | $533 | — | $533 | 100.00% |
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 | 228 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP SELECT CARE | 213 | $75K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $42K |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 73 | $533 |
| Other(2 contracts, 2 carriers) | AFLAC | 50 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.