| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KRISTINE A ZABRISKIE3 Filed as: KRISTINE L KELLOGG | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5K | $0 | $5K | 3.87% |
| BRIAN BEAUCHEMIN3 | 334 GRAY ST HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4K | $44 | $4K | 3.18% |
| DONALD H MATSON3 | 8 ROSEWOOD DR AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3K | $453 | $3K | 2.54% |
| MELISSA PINE3 | 334 GRAY STREET HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $232 | $2K | 1.68% |
| MARIE TREAT3 | 314 S SEWARD AVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $893 | $0 | $893 | 0.72% |
| MISTY L PHELAN3 | 1237 DUTCH HILL RD TULLY, NY 13159 | THE PAUL REVERE LIFE INSURANCE COMPANY | $783 | $1 | $784 | 0.63% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: GILROY KERNAN & GILROY | PO BOX 452 NEW HARTFORD, NY 13413 | THE PAUL REVERE LIFE INSURANCE COMPANY | $765 | $0 | $765 | 0.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 110 LANGLEY ROAD ROME, NY 13441 | THE PAUL REVERE LIFE INSURANCE COMPANY | $117 | $0 | $117 | 0.09% |
| ASHLEY GRANATO3 | 4 EASTERN PARKWAY AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $28 | $0 | $28 | 0.02% |
| JOSEPH PAUL PEPLINSKI3 | 4243 CANOE CREEK LANE LIVERPOOL, NY 13090 | THE PAUL REVERE LIFE INSURANCE COMPANY | $11 | $1 | $12 | 0.01% |
| WAYNE SCHUTT3 | 66 HAMLIN STREET CORTLAND, NY 13045 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| MATSON & KELLOGG BENEFITS GROUP LLC3 | 8889 S SENECA ST WEEDSPORT, NY 13166 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 2.75% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: GILROY KERNAN & GILROY INC | 210 CLINTON RD NEW HARTFORD, NY 13413 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $15 | $1K | 2.27% |
| MARY R COLEMAN | 44 RIDGE RD RENSSELAER, NY 12144 | AFLAC | $1K | — | $1K | 11.16% |
| BETH SERFILIPPI | 8 HILLSTONE CT BALLSTON LAKE, NY 12019 | AFLAC | $240 | — | $240 | 2.09% |
| DANA E ERO Filed as: DANA ERO | 5 PINE WEST PLZ STE 503 ALBANY, NY 12205 | AFLAC | $225 | — | $225 | 1.96% |
| KRISTA ANNE ROTONDI | 5 PINE WEST PLZ STE 503 ALBANY, NY 12205 | AFLAC | $171 | — | $171 | 1.49% |
| DARRYL J YOUNG | 3820 GOLD CITY RD FRANKLIN, KY 42134 | AFLAC | $106 | — | $106 | 0.92% |
| SUSAN M TODD-BEDELL | 249 N BALLSTON AVE SCOTIA, NY 12302 | AFLAC | $63 | — | $63 | 0.55% |
| DEBORAH M TALLMAN | 3 LENNOX STREET APT E CLIFTON PARK, NY 12065 | AFLAC | $60 | — | $60 | 0.52% |
| MCINERNEY GROUP LLC | 580 WHITE PLAINS RD STE 115 TARRYTOWN, NY 10591 | AFLAC | $35 | — | $35 | 0.31% |
| ROSANN M CURRAN | 1536 RIDGE RD QUEENSBURY, NY 12804 | AFLAC | $20 | — | $20 | 0.17% |
| KEVIN MCCARTHY | 197 LANG DR NORTH KINGSTOWN, RI 02852 | AFLAC | $14 | — | $14 | 0.12% |
| JANINE FOX Filed as: JANINE M FOX | 18 HAVILAND DR SCHENECTADY, NY 12302 | AFLAC | $12 | — | $12 | 0.10% |
| KELLY A IRVINE | 15801 WHITE ORCHID LN FORT MYERS, FL 33908 | AFLAC | $11 | — | $11 | 0.10% |
| TOMAS E FLORES | 1265 15TH ST APT 16 G FORT LEE, NJ 07024 | AFLAC | $7 | — | $7 | 0.06% |
| LISA J BRENNAN-JONES | 1014 CATHERINE WOODS SCHENECTADY, NY 12309 | AFLAC | $6 | — | $6 | 0.05% |
| JEFF DALABA | 8500 GILLY FLOWER CT BALDWINSVILLE, NY 13027 | AFLAC | $3 | — | $3 | 0.03% |
| LAURIE L SMITH | 577 TRUESDALE HILL RD LAKE GEORGE, NY 12845 | AFLAC | $1 | — | $1 | 0.01% |
| RANDI E RIVA | 340 W PALMETTO PARK RD UNIT 504B BOCA RATON, FL 33432 | AFLAC | $1 | — | $1 | 0.01% |
| MATSON & KELLOGG BENEFITS GROUP LLC3 | 8889 S SENECA ST WEEDSPORT, NY 13166 | HM LIFE INSURANCE COMPANY OF NEW YORK | $350 | $0 | $350 | 5.30% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: GILROY KERNAN & GILROY INC | 210 CLINTON RD NEW HARTFORD, NY 13413 | HM LIFE INSURANCE COMPANY OF NEW YORK | $310 | $0 | $310 | 4.70% |
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 | 178 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP SELECT CARE | 178 | $72K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 141 | $46K |
| Vision | HM LIFE INSURANCE COMPANY OF NEW YORK | 75 | $7K |
| Other(2 contracts, 2 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 59 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.