| 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 | $14K | $0 | $14K | 7.42% |
| DONALD H MATSON3 | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $13K | $0 | $13K | 6.70% |
| ASHLEY GRANATO3 | 4 EASTERN PARKWAY AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7K | $278 | $7K | 3.96% |
| MARIE TREAT3 | 314 SOUTH SEWARD AVENUE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.59% |
| JON PICHE3 | 220 BALL ROAD HASTINGS, NY 13076 | THE PAUL REVERE LIFE INSURANCE COMPANY | $869 | $43 | $912 | 0.49% |
| LISA T GARRIGAN3 | 3257 WALKER ROAD AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $256 | $0 | $256 | 0.14% |
| MISTY L PHELAN3 | 3247 SCOTIA STREET PORT CHARLOTTE, NY 33952 | THE PAUL REVERE LIFE INSURANCE COMPANY | $74 | $0 | $74 | 0.04% |
| KRISTINE KELLOGG3 | 8889 SOUTH SENECA STREET PO BOX 321 WEEDSPORT, NY 13144 | EXCELLUS BLUE CROSS BLUE SHIELD | $5K | $0 | $5K | 9.29% |
| DONALD H MATSON3 Filed as: DONALD MATSON | 8 ROSEWOOD DR AUBURN, NY 13021 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $0 | $3K | 7.24% |
| DONALD H MATSON3 Filed as: DONALD MATSON | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 13.72% |
| KRISTINE KELLOGG3 | 8889 SOUTH SENECA STREET PO BOX 321 WEEDSPORT, NY 13144 | EXCELLUS BLUE CROSS BLUE SHIELD | $867 | $0 | $867 | 10.03% |
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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | THE PAUL REVERE LIFE INSURANCE COMPANY | 152 | $186K |
| Dental | EXCELLUS BLUE CROSS BLUE SHIELD | 107 | $55K |
| Vision | EXCELLUS BLUE CROSS BLUE SHIELD | 89 | $9K |
| Life insurance(3 contracts, 2 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 162 | $251K |
| Short-term disability | THE PAUL REVERE LIFE INSURANCE COMPANY | 152 | $186K |
| Other(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 162 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.