| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: HAYLOR FREYER & COON INC | 105 DOWNING ROAD SYRACUSE, NY 132141546 | METROPOLITAN LIFE INSURANCE COMPANY | $973 | $15 | $988 | 2.64% |
| MATSON & KELLOGG BENEFITS GROUP LLC3 Filed as: MATSON & KELLOGG BENEFITS GROUP | 8889 SOUTH SENECA STREET WEEDSPORT, NY 13166 | METROPOLITAN LIFE INSURANCE COMPANY | $772 | $13 | $785 | 2.10% |
| MARY R COLEMAN | 44 RIDGE ROA RENSSELAER, NY 12144 | AFLAC | $3K | $38 | $3K | 8.64% |
| BETH SERFILIPPI | 9 HILLSTONE CT BALLSTON LAKE, NY 12019 | AFLAC | $711 | — | $711 | 2.06% |
| SUSAN M TODD-BEDELL | 249 N BALLSTON AVE SCOTIA, NY 12302 | AFLAC | $653 | — | $653 | 1.89% |
| BRENDA MALANEY GORE | 30 OLD GLORY LN BALLSTON SPA, NY 12020 | AFLAC | $432 | — | $432 | 1.25% |
| KRISTA ANNE ROTONDI | 5 PINE WEST PLZ STE 503 ALBANY, NY 12205 | AFLAC | $363 | $8 | $371 | 1.08% |
| DARRYL J YOUNG | 4522 SHADY PLACE COURT BOWLING GREEN, KY 42104 | AFLAC | $303 | — | $303 | 0.88% |
| DEBORAH M TALLMAN | 316A GULF ROAD COHOES, NY 12047 | AFLAC | $151 | $8 | $159 | 0.46% |
| MCINERNEY GROUP LLC | 580 WHITE PLAINS RD STE 115 TARRYTOWN, NY 10591 | AFLAC | $100 | — | $100 | 0.29% |
| CHARITY NICOLE CATALFAMO | 1705 HILLCREST AVE CASTLETON ON HUDSON, NY 12033 | AFLAC | $84 | — | $84 | 0.24% |
| JANINE FOX Filed as: JANINE M FOX | 5303 HARMONY MILLS WEST CAHOES, NY 12047 | AFLAC | $78 | — | $78 | 0.23% |
| KEVIN MCCARTHY | 197 LANG DR NORTH KINGSTOWN, RI 02852 | AFLAC | $39 | — | $39 | 0.11% |
| ROSANN M CURRAN | 1536 RIDGE RD QUEENSBURY, NY 12804 | AFLAC | $20 | — | $20 | 0.06% |
| TOMAS E FLORES | 1265 15TH ST APT 16G FORT LEE, NJ 07024 | AFLAC | $20 | — | $20 | 0.06% |
| CATHY HEDBERG | 663 WESTERN AVE ALBANY, NY 12203 | AFLAC | $18 | — | $18 | 0.05% |
| KELLY A IRVINE | 333 GLEN STREET SUITE 201 GLENS FALLS, NY 12801 | AFLAC | $13 | — | $13 | 0.04% |
| LAURA GINGERESKY | 7 WOODBINE AVE WATERVLIET, NY 12189 | AFLAC | $13 | — | $13 | 0.04% |
| LISA J BRENNAN-JONES | 1014 CATHERINE WOODS SCHENECTADY, NY 12309 | AFLAC | $6 | — | $6 | 0.02% |
| BENITO A ROTONDI II INC | 23 PINE RIDGE RD SARATOGA SPRINGS, NY 12866 | AFLAC | $6 | — | $6 | 0.02% |
| BRAD JONES AND ASSOCIATES INC | 19 BRITISH AMERICAN BLVD LATHAM, NY 12110 | AFLAC | $4 | — | $4 | 0.01% |
| JEFF DALABA | 8500 GILLY FLOWER COURT BALDWINSVILLE, NY 13027 | AFLAC | $3 | — | $3 | 0.01% |
| SUSAN C BRIMHALL | 3921 CAPE SAN BLAS RD PORT SAINT JOE, FL 32456 | AFLAC | $3 | — | $3 | 0.01% |
| KEVIN MURPHY | 11 WILLBROOK TERRACE CLIFTON PARK, NY 12065 | AFLAC | $2 | — | $2 | 0.01% |
| ROSE & KIERNAN INC Filed as: ROSE AND KIERNAN INC | 99 TROY RD STE 3 EAST GREENBUSH, NY 12061 | AFLAC | $2 | — | $2 | 0.01% |
| RANDI E RIVA | 213 GALLERY LANE MOUNT BETHEL, PA 18343 | AFLAC | $1 | — | $1 | 0.00% |
| LAURIE L SMITH | 577 TRUESDALE HILL RD LAKE GEORGE, NY 12845 | AFLAC | $1 | — | $1 | 0.00% |
| IRMA MATILDE WOODARD | 7684 STATE ROUTE 66 AVERILL PARK, NY 12018 | AFLAC | $1 | — | $1 | 0.00% |
| BRIAN BEAUCHEMIN | 215 MARION ST HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5K | $2K | $7K | 25.87% |
| KRISTINE A ZABRISKIE Filed as: KRISTINE L KELLOGG | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5K | — | $5K | 19.36% |
| DONALD H MATSON3 | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3K | $1K | $4K | 15.78% |
| MARIE TREAT | 314 S SEWARD AVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $1K | $3K | 11.58% |
| MELISSA PINE | 215 MARION ST HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $1K | $2K | 8.48% |
| MISTY L PHELAN | 1237 DUTCH HILL ROAD TULLY, NY 13159 | THE PAUL REVERE LIFE INSURANCE COMPANY | $567 | — | $567 | 2.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY INC | 117 WEST LIBERTY ST ROME, NY 13440 | THE PAUL REVERE LIFE INSURANCE COMPANY | $122 | — | $122 | 0.47% |
| ASHLEY GRANATO3 | 4 EMMA ST AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $29 | — | $29 | 0.11% |
| MATSON & KELLOGG BENEFITS GROUP LLC3 Filed as: MATSON & KELLOGG BENEFITS GROUP | 8889 SOUTH SENECA STREET WEEDSPORT, NY 13166 | HM LIFE INSURANCE COMPANY OF NY | $310 | — | $310 | 5.68% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY INC | 500 PLUM ST STE 200 SYRACUSE, NY 13204 | HM LIFE INSURANCE COMPANY OF NY | $237 | — | $237 | 4.34% |
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 | 192 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTH CARE | 197 | $73K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 151 | $37K |
| Vision | HM LIFE INSURANCE COMPANY OF NY | 71 | $5K |
| Other(2 contracts, 2 carriers) | AFLAC | 91 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.