| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KRISTINE KELLOGG3 | 8889 SOUTH SENECA STREET PO BOX 321 WEEDSPORT, NY 13144 | EXCELLUS BLUE CROSS BLUE SHIELD | $37K | — | $37K | 4.32% |
| KRISTINE A ZABRISKIE3 Filed as: KRISTINE L KELLOGG | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $13K | — | $13K | 7.16% |
| DONALD H MATSON3 | 8 ROSEWOOD DR AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $9K | $2K | $11K | 6.36% |
| ASHLEY GRANATO3 | 4 EASTERN PARKWAY AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5K | $197 | $5K | 2.74% |
| MARIE TREAT3 | 314 S SEWARD AVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $9 | $1K | 0.60% |
| LISA T GARRIGAN3 | 3257 WALKER ROAD AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $406 | $219 | $625 | 0.36% |
| JON PICHE3 | 212 HALEY ST WATERTOWN, NY 13601 | THE PAUL REVERE LIFE INSURANCE COMPANY | $477 | — | $477 | 0.27% |
| MISTY L PHELAN3 | 1237 DUTCH HILL ROAD TULLY, NY 13159 | THE PAUL REVERE LIFE INSURANCE COMPANY | $93 | — | $93 | 0.05% |
| MATSON & KELLOGG BENEFITS GROUP LLC3 | 8889 S SENECA ST WEEDSPORT, NY 13166 | UNITED CONCORDIA INSURANCE COMPANY OF NEW YORK | $3K | — | $3K | 6.47% |
| DONALD H MATSON3 Filed as: DONALD MATSON | 8 ROSEWOOD DR AUBURN, NY 13021 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 8.40% |
| DONALD H MATSON3 Filed as: DONALD MATSON | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| DONALD H MATSON3 | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $977 | — | $977 | 9.80% |
| CYNTHIA LERNER RUBIN3 Filed as: CYNTHIA P WHALEN | 123 PINE VALLEY DR MIDDLETOWN, DE 19709 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.53% |
| DONALD H MATSON3 | 8 ROSEWOOD DR AUBURN, NY 13021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.33% |
| CYD M WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.09% |
| STEPHEN M HENSS LLC3 | 44 HERSHEY LANE PARKSBURG, PA 19365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.07% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.02% |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | EXCELLUS BLUE CROSS BLUE SHIELD | 128 | $1.0M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY OF NEW YORK | 156 | $52K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 62 | $10K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 124 | $44K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 93 | $860K |
| Other(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 124 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.